新型喉罩在腹腔镜盆腔肿瘤切除术麻醉中的应用  

Application of NLMA in anesthesia of pelvic tumor laparoscopic excision

作　　者：肖红[1] 刘玲[1] 李家峰[1] 李锦城[1] 

机构地区：[1]天津医科大学附属肿瘤医院麻醉科,天津300060

出　　处：《中华肿瘤防治杂志》2007年第8期625-627,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：探讨新型喉罩(NLMA)在腹腔镜盆腔肿瘤切除术麻醉中的可行性。采用弹性树脂探条引导法置入NL-MA,记录NLMA置入前即刻、置入后1、3、5和10min及气腹后5、10、20和30min时收缩压(SP)、舒张压(DP)、心率(HR),呼气末二氧化碳分压(PETCO2)和脉搏血氧饱和度(SpO2)变化,同时观察NLMA通气罩在不充气、充气10、20和30mL时,分别在气道压20、30和40cmH2O水平,患者处于头正中位、屈曲位、过伸位和侧位的气道密封效果。NLMA置管成功率100%,血液动力学、PETCO2及SpO2稳定(P>0.05),喉罩气囊不充气,气道压20cmH2O时,76.5%～77.9%不漏气;充气30mL气道压低于30cmH2O时,91.8%～97.5%不漏气,气道压40cmH2O时,5例少量漏气。各种头位不影响气道密闭效果。95.6%患者胃管1次置入成功,纤支镜证实NLMA位置好,术后无不良反应。初步结果提示,NLMA可安全用于腹腔镜盆腔肿瘤切除术。The objective of this stady was to investigate the safety of using new laryngeal mask airway （NI.MA） in anesthesia of pelvic tumor laparoseopic excision. Methods： Laparoscopic surgery was performed in 68 ASA Ⅰ-Ⅲ patients with pelvic tumors. NI.MA was inserted by using gum-elastic bougie-guided technique, BP, HR, SpO2 and PET CO2 were continuously monitored during the anesthesia. The airway sealing effect of NLMA was examined whh cuff deflated and inflated with 10, 20 and 30 ML of air when airway pressure （Paw） was maintained at 20,30 and 40 cm H2O respectively in 4 head and neck positions （neutral, flexed, extended and turned to side）. Fiberoptic broncho scope was inserted into the airway tube of NLMA to check its position and into the drainage tube to cheek its patency. The overall success rate of NLMA insertion was 100%. BP, HR, SpO2 and PET CO2 were stable （P〉0.05）. With cuff deflated 76.5%-77.9% of NLMA didn＇t leak at 20 cm H2O of Paw; with 30 mL cuff volume 91.8%-97.5% of NLMAs did not leak at Paw 〈30 cm H2O; with 30 mL cuff volume only 5 NLMAs developed mild leakage at Paw of 40 cm H2O. Different head and neck positions didn＇t change NLMA airway sealing effect. The success rate of gas tric tube insertion at first-attempt was 95. 6%. Fiberoptic bronchoscopy showed that NLMA was in good positon and drainage tube patent. No complications developed after the operation. Conclusion：NLMA can be safely used in anesthesia of pelvic tumor laparoscopic excision.

关 键 词：盆腔肿瘤/外科手术 腹腔镜检查 妇科外科手术 喉面罩 麻醉 全身 

分 类 号：R614[医药卫生—麻醉学]