气管插管和放置喉罩对全麻用药量的影响  

The effects of postoperative awakening time between endotracheal intubation and laryngeal mask airway in total intravenous anesthesia

作　　者：陈学新[1] 马汉祥[1] 孟尽海[1] 刘红[1] 潘华[1] 施伟忠[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2007年第12期1090-1092,共3页Ningxia Medical Journal

摘　　要：目的研究放置气管导管和喉罩在全身静脉麻醉中对麻醉用药量的影响。方法选择ASAI-II级静脉全麻病人40例,分为喉罩组与插管组,行机械通气,应用HXD-I型多功能定量脑电图监测仪,行麻醉深度控制(收缩压±20%和双频谱指数40-60)。手术结束后3、6、9、12、15、20分钟使用OAA/S(警觉镇静评分)评分并记录相应的B IS。结果LMA(喉罩)组异丙酚的用量和瑞芬太尼用量比插管组明显减少(P(0.05),LMA组在9、12、15分钟OAA/S评分高于插管组,其它时间点没有明显差异,两组B IS值除了3分钟没有明显差异外,在其它时间点LMA组均高出插管组。拔出通气管时间喉罩组较插管组明显缩短。两组OAA/S评分与B IS的相关系数及概率:3分钟(r=0.24,P=0.3)、6分钟(r=0.43,P=0.06)、9分钟(r=0.81,P<0.001)、12分钟(r=0.779,P<0.001)、15分钟(r=0.791,P<0.001)、20分钟(r=0.667,P=0.03)。结论喉罩在全身麻醉中较气管插管舒适,麻醉用药量明显减少、术后清醒时间明显提前,是一种良好的通气工具。Objective The effects of postoperative awakening time between endotracheal intubation and laryngeal mask airway （LMA） in total intravenous anesthesia （TIVA）. Methods ASA （ Ⅰ - Ⅱ） patients of TIVA were randomly divided into intubation group （ n = 20） and LMA group （ n = 20）. The anesthesia depth was determined and controlled to basal value of SBP ＋ 20% and BIS 40 - 60. The OAA/S score and BIS value was recorded 3min, 6min, 9min, 12rain, 15min and 20min after operation, respectively. Results The OAA/S score in LMA group was significantly higher than that in intubation group in 9rain, 12rain and 15min, respectively. BIS value was high in LMA group than that in intubation ones except 3min and time of extubation in LMA was shorter than that in intubation ones. The correlation index and possibility between OAA/S and BIS were 3min （ r =0.24, P =0.3）, 6min （ r =0.43, P =0.06）, 9min （ r =0.81, P =0.00）, 12min （ r =0.779, P =0.00）, 15min（ r =0.791, P =0.00）, 20min （ r =0.467, P =0.04）, respectively. Conclusion LMA can provide a smoother induction with a stable hemodynamic profile, less postoperative awakening time and less technical demand.

关 键 词：全身静脉麻醉 气管插管 LMA OAA/S评分 

分 类 号：R614[医药卫生—麻醉学]