喉罩在小儿先天性心脏病介入治疗麻醉中的应用  

The application of laryngeal mask airway for general anesthesia in the interventional therapy of children with congenital heart disease

作　　者：王晓亮[1] 赵倩[1] 徐丽[1] 尹加林[1] 史宏伟[1] 鲍红光[1] 

机构地区：[1]南京医科大学附属南京第一医院麻醉科,210006

出　　处：《中华临床医师杂志（电子版）》2011年第18期5286-5289,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探索喉罩在小儿先天性心脏病介入治疗麻醉中应用的可行性和安全性。方法选择ASAⅠ～Ⅱ级,择期先天性心脏病介入治疗的患儿60例,随机分为喉罩组和气管插管组,每组各30例。喉罩组麻醉诱导,静脉注射丙泊酚1.5mg/kg、雷米芬太尼2μg/kg,药物达峰效应后置入喉罩;气管插管组麻醉诱导时加用罗库溴铵0.6mg/kg。麻醉维持采用丙泊酚和雷米芬太尼持续输注。分别记录两组患儿手术时间、苏醒时间、麻醉诱导前、麻醉诱导后及喉罩或导管置入前、置入后、拔除前、拔除后的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)值,并对置入喉罩和气管插管的一次成功率进行比较。监测术毕麻醉后恢复情况。结果两组患儿手术时间、苏醒时间、麻醉诱导前及喉罩或导管置入前、拔除前MAP、HR、SpO2值比较差异无统计学意义(P>0.05);喉罩或导管置入后及术后拔除时喉罩组MAP、HR低于气管插管组(P<0.05);术后呼吸系统并发症喉罩组少于气管插管组(P<0.05)。结论喉罩应用于小儿先天性心脏病介入治疗全麻,患儿血流动力学平稳、呼吸道并发症少,安全可靠性优于全麻插管,值得临床推广。Objective To explore the effects of the application of laryngeal mask airway and compare it with traditional endotracheal intubation in children with congenital heart disease during general anesthesia.Methods Sixty children(ASA Ⅰ～Ⅱ) with congenital heart disorders,were randomly divided into two groups:laryngeal mask airway group (LMA group,30 cases) and endotracheal intubation group (TT group,30 cases).LMA was inserted followed by intravenous infusion of propofol 1.5 mg/kg and remifentanil 2 μg/kg in LMA group,while endotracheal intubation was set up following the using of propofol 1.5 mg/kg,remifentanil 2 μg/kg and rocuronium 0.6 mg/kg in TT group.Anesthesia was maintained with intravenous infusion of propofol and remifentanil.The time for operation and recovery from anaesthesia,the values of MAP,HR,SpO2 was recorded at different terms in two groups (before anesthesia,before implantation of LMA or TT,after implantation of LMA or TT,before and after the removal of LMA or TT.Also,the first successful placement was compared in two groups.Results There were no significant differences for general information in two groups,such as the time for operation and recovery from anesthesia,the values of MAP,HR,SpO2 before induction,before the LMA (TT) placed,before the removal of the LMA (TT) (P>0.05).However,the values of MAP,HR,SpO2 were significantly higher in TT group than that in LMA group at application of endotracheal tube and extubation points (P<0.05).Postoperative respiratory complications in LMA group was significantly lower than that in the TT group.Conclusions Application of laryngeal mask airway for general anesthesia in the interventional therapy of children with congenital heart disease not only could achieve an effect of hemodynamic-stabilization,but also reduce postoperative respiratory complications because of its less response of stress.

关 键 词：儿童 心脏病 麻醉 喉面罩 

分 类 号：R726.1[医药卫生—儿科]