低浓度罗哌卡因硬外阻滞复合喉罩通气在乳腺癌根治术的应用  

Application of Low Concentration Ropivacaine Epidural Block with Laryngeal Mask Ventilation in Breast Cancer Radical Correction

作　　者：王远胜[1] 黄漫[1] 阳兴[1] 

机构地区：[1]广东省江门市中心医院,529000

出　　处：《内蒙古中医药》2008年第11期3-5,共3页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的:观察低浓度罗哌卡因硬外阻滞复合喉罩通气在乳腺癌根治术应用的安全性、有效性。比较硬外阻滞复合喉罩(LMA)和气管内插管(B)在乳腺癌手术中应用,观察插入喉罩和气管导管及拔除喉罩和气管导管时血流动力学变化,及术中SPO2、PETCO2以及两组拔管期的不良反应及术后并发症。方法:60例女性择期乳腺癌病人ASAⅠ-Ⅱ级,随机分为硬外喉罩组(L组)和气管插管组(B组)两组,每组30例。观察麻醉前(T0)、插管或放喉罩后1分钟(T1)、插管或放喉罩后15分钟(T2)、手术后拔管或喉罩后即刻(T3)的MAP、HR,及术中的PETCO2、SPO2,术后48小时(T4)随访有无咽痛、声嘶咳嗽等不适。结果:硬外喉罩组T1和T3时段MAP、HR与气管插管组比较明显降低(P<0.05),气管插管组T4时段咽痛发生率与喉罩组相比明显增多(P<0.01)。两组病人PETCO2差异无显著性意义,其他各时段MAP、HR组间比较差异无显著性意义。结论:低浓度罗哌卡因硬外阻滞复合喉罩通气可安全用于乳腺癌手术,可发挥硬膜外麻醉优点,充分镇痛,有效维持术中通气,病人舒适,术后并发症少等优点。Objective.. To observe the safety and efficacy when low concentration ropivacaine epidural block with laryngeal mask ventilation used in breast cancer radical correction. Methods ：60 ASA Ⅰ -- Ⅱ elective patients undergoing in breast cancer radical correction were randomly allocated to either epidural block with laryngeal mask group L （L,n= 30） or tracheal tube groupB（B, n = 30）, MAP, HR of patients before anaesthesia（T0） / at the time of one minute （T1）and 15 minutes （T2）after r intubation tracheal tube or laryngeal mask intubation and after extubation tracheal tube or laryngeal mask（T3） were recorded. Monitor PET- CO2 ,and SPO2 of patients. Postoperational complications were aslo recorded 48 hours after operation （T4）. Monitor PETCO2 and SPO2. Results： HR and MAP in Group B were significantly increased at T1 和 T3 than in Group L（P〈0.05）, pharyngodynia incidence rate in Group B was notable increased than in Group L（P〈0.01）. There were no marked differences of PETCO2 of both group L and groupB （P〉0.05）. HR and MAP at other time had no notable difference in both group L and groupB （P〉0.05） Conclusion： Application of low concentration ropivacaine epidural block with laryngeal mask ventilation in breast cancer radical correction is safe , it can reduce physiological interference and circulation function is steady , it can bring about fewer complications and make the patients felt comfortable.

关 键 词：罗哌卡因 硬外阻滞 喉罩 乳腺癌根治术 

分 类 号：R614[医药卫生—麻醉学]