喉罩通气在婴幼儿眼科手术麻醉中的应用  

The usage of laryngeal mask airway for Ocular Trauma anesthesia in children

作　　者：张化[1] 张卫[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,河南郑州450052

出　　处：《眼外伤职业眼病杂志》2008年第10期813-815,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨婴幼儿眼科手术应用喉罩、面罩与气管内插管通气对患儿呼吸、循环及术后并发症的影响。方法婴幼儿外伤性白内障摘出人工晶状体植入术120例，年龄3～9岁，随机分为3组（每组40例）：喉罩通气组（A组）、面罩通气组（B组）、气管内插管通气组（c组）。3组均行静脉注射瑞芬太尼1μg／kg、异丙酚2．5mg／kg诱导，A组置人2～2．5。喉罩；B组面罩供氧；C组另静脉注射阿曲库铵0．5mg／kg后行气管内插管。记录麻醉诱导前、插入气管导管（喉罩）时、拔出气管导管（喉罩）时的血压、心率、术中脉搏氧饱和度及术后咽喉部疼痛和声音嘶哑情况。结果A组置入、拔出喉罩时血压、心率与基础值比较无明显变化，B组术中脉搏氧饱和度低于90％者发生率明显高于A、C组（P〈0．05），C组气管插管、拔管时血压、心率比诱导前明显升高（P〈0．05），术后随访有声音嘶哑等并发症。结论喉罩通气对呼吸、循环影响较小，能保证充分供氧，对喉头、气管无损伤，是婴幼儿眼科手术的最佳选择。Objective To compare the effects of laryngeal mask airway ventilation, mask ventilation and endotracheal intubation ventilation on respiratory, hemodynamic function and postoper- ational complications to ocular trauma operation in children. Methods One hundred and twenty children aged 3 -9yrs scheduled for ECCE ＋ IOL surgery under general anesthesia were randomly allocated to one of 3 groups （ n = 40 each） ： group A, larynegeal mask airway ventilation ; group B, mask ventilation ; group C, endotracheal intubation ventilation. Anesthesia were induced with remifentanil 1μg/kg and propofol 2. 5 mg/kg, laryngeal mask airway were intubated in group A, oxygen was supplied by mask in group B, in group C atraeurium 0. 5 mg/kg was injected IV before endotracheal intubation, Noninvasive BP, HR were recorded before, during intubation, extubation, and SOP2 in operation, pain of laryngopharynx and hoarseness after operation. Results Copmare with baseline BP and HP, there was no significantly change in group A while take in and take out laryngeal mask airway, in group B incidence of SPO2 less 90 percent was significantly exceed group A and C,. BP and HP were significantly increased in group C as endotracheal intubation and extubation （ P 〈 0. 05 ）, group C also had postoperational complications such as voice hoarseness. Condusion laryngeal mask airway ventilation has little influence on respiration, circulation and more effectively than mask ventilation and endotracheal intubation ventilation in children, it is the best choice to children ocular trauma surgery.

关 键 词：喉罩通气 麻醉 全身 婴幼儿 插管法 气管内 

分 类 号：R726.1[医药卫生—儿科]