双管型喉罩在妇科腹腔镜手术麻醉中的应用  

Application of proseal laryngeal mask in gynaecological laparoscopy under general anesthesia

作　　者：李海冰[1] 周守静[1] 梁伟民[1] 王丽红[1] 刘志强[2] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海200001 [2]同济大学附属上海市第一妇婴保健医院麻醉科,上海200040

出　　处：《中国内镜杂志》2007年第10期1056-1059,共4页China Journal of Endoscopy

摘　　要：目的比较全身麻醉下妇科腹腔镜手术患者应用双管型喉罩和气管导管时呼吸和循环的变化。方法妇科腹腔镜择期手术病人60例,ASAⅠ、Ⅱ,随机分为喉罩组(LAM组,30例)和气管插管组(TT组,30例),麻醉后记录心率(HR)、平均动脉压(MAP)、气道峰压(Pmax)、气道平均压(Pmean)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)、动脉血二氧化碳分压(PaCO2)、肺动态顺应性(CL)的数值及插管(罩)期、拔管(罩)期、术后24h相关并发症。结果①HR、MAP变化:插管(罩)期和拔管(罩)期TT组明显升高(P<0.05),LAM组无明显变化(P>0.05)。②两组PETCO2、PaCO2、Pmax、Pmean随麻醉、气腹的影响变化是一致的,组间比较各时间点差异无显著性(P>0.05),两组的SpO2一直保持稳定水平。结论该研究显示妇科腹腔镜手术中双管型喉罩可以达到与气管插管一样满意的通气效果,应激反应小,且安全可靠。[Objective] To observe the safey and efficacy of LAM-Proseal used in gynecologic laparoscopy under positive pressure ventilation. [Methods] Fifty patients undergoing elective gynaecological laparoscopy were randomly allocated to either laryngeal mask airway group （LAM, n =30） or tracheal tube group （TT, n =30）. After anesthesia induction and tracheal ro laryngeal mask in tubation, HR, interval noninvasive MBp, SpO2, PETCO2, Pmax, Pmean, and PaCO2 laryngeal mask introcuff pressure （Pcuff） were monitored. [Results] HR and MBP in group TT were significantly increased after insertion and before extubation, which was not in group LAM. SpO2 had no change during operation in tow groups. PETCO2, PaCO2, Pmax, Pmean, CL were similar at all the time points between the two groups. Group TT had bighter incidence of body movement and coughing before extubation （P 〈0.05）, and higher incidence of sore throat postoperatively. There was no significant difference in the quality of sfirgical condition between the two groups. [Conclusion] LMA-Proseal can provide the same safe and effective ventilation as tracheal intubation gynaecological laparoscopy.

关 键 词：双管型喉罩 妇科腹腔镜手术 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]