食管引流型与标准型喉罩通气道在全身麻醉患者的应用  被引量:63

A comparsion of ProSeal laryngeal mask airway and standard laryngeal mask airway in the patients undergoing general anesthesia

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作  者:毛鹏[1] 薛富善[1] 李成文[1] 刘鲲鹏[1] 许亚超[1] 刘毅[1] 张国华[1] 孙海涛[1] 

机构地区:[1]中国医学科学院中国协和医科大学整形外科医院麻醉科,北京市100041

出  处:《临床麻醉学杂志》2006年第9期643-645,共3页Journal of Clinical Anesthesiology

摘  要:目的 比较食管引流型喉罩通气道(PLMA)和标准型喉罩通气道(SLMA)在全身麻醉患者的应用。方法 ASAⅠ~Ⅱ级择期整形外科手术患者60例,随机均分为PLMA组和SLMA组,常规麻醉诱导后,分别插入PLMA或SLMA,并将通气罩充气至60cmH2O。评价两种喉罩通气道的插入特征、气道密封压和漏气部位,记录麻醉诱导前后、喉罩插入时和喉罩插入后5min内SBP、DBP和HR的变化情况。记录麻醉期间发生的呼吸并发症和呼吸道损伤情况。结果 PLMA组首次插入即获得满意肺通气的例数高于SLMA组,但PLMA组操作时间明显长于SLMA组(P〈0.05)。PLMA组通气罩充气量和气道密封压明显高于SLMA组(P<0.05)。两组插入操作所致的血液动力学反应相似,而且均非常轻微。结论 与SLMA相比,PLMA可达到更好的气道密封性,并可提供良好的胃管插入通路,是全身麻醉患者安全有效的呼吸道管理工具之一。Objective To compare the application of ProSeal laryngeal mask airway (PLMA) with standard laryngeal mask airway(SLMA) in the patients undergoing general anesthesia. Methods Sixty adult patients, ASA physical status Ⅰ-Ⅱ , aged 18-49 y, scheduled for elective plastic surgery under general anesthesia were randomly allocated to either PLMA group or SLMA group. After intravenous anesthesia induction,PLMA or SLMA was inserted by routine methods. The intracuff pressure was set at 60 cmH2O. Noninvasive SBP,DBP and HR were recorded before and after anesthesia induction, during insertion, at 5 min after insertion. Insertion manipulation, efficacy of lung ventilation, cuff inflation volume, airway leak pressure, locations of gas leak, gastric tube placement through the PLMA and airway and respiratory complications were assessed. Results All patients in PLMA group achieved satisfactory lung ventilation at the first attempt. The insertion time was significantly longer in PLMA group than that in SLMA group. The cuff inflation volume and airway seal pressure were higher in PLMA group than those in SLMA group. The Hemodynamic responses to insertion in the both groups were similar and minimal. Conclusion Compared with SLMA,PLMA can achieve a higher airway seal pressure and provides an easy passage of a gastric tube. PLMA is a safe and effective airway management device in the patients undergoing general anesthesia.

关 键 词:食管引流型喉罩通气道 标准型喉罩通气道 肺通气 血液动力学反应 并发症 

分 类 号:R614.2[医药卫生—麻醉学]

 

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