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机构地区:[1]安徽医科大学第二附属医院麻醉科,230601
出 处:《中国医药指南》2010年第22期12-14,共3页Guide of China Medicine
摘 要:目的观察ProSeal喉罩全麻在妇科腹腔镜手术中应用的有效性和安全性。方法选择妇科腹腔镜手术患者50例,ASAⅠ-Ⅱ级,随机分为ProSeal喉罩组(P组n=25)和气管插管组(T组n=25),麻醉诱导插管后,观察心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SPO2)、呼气末二氧化碳分压(PETCO2)、气道峰压(Ppeak)、气道平均压(Pmean),并记录两组拔管期的不良反应及术后并发症等。结果 P组在喉罩置入和拔出前后的时间点HR、MAP无明显变化(P〉0.05),T组插管后即刻和拔管后即刻HR、MAP均显著升高(P〈0.05)。两组PETCO2、Ppeak、Pmean随气腹的影响变化一致,组间比较差异无统计学意义(P〉0.05)。拔管期间P组发生的体动、呛咳较T组明显减少,差异有统计学意义(P〈0.05),套囊血迹及术后咽喉痛、声嘶两组比较差异无统计学意义(P〉0.05)。结论本研究显示,在全麻妇科腹腔镜手术中ProSeal喉罩可达到与气管插管一样满意的通气效果,且心血管应激反应小,体动、呛咳发生率减少。Objective To observe the safety and efficacy when Proseal laryngeal mask(LAM) used in gynaecological laparoscopy operation under positive pressure ventilation.Methods Fifty ASA Ⅰ-Ⅱ patients undergoing elective general anesthetic operation were randomly allocated to either Proseal laryngeal mask airway group(P,n=25) or tracheal tube group(T,n=25).After anesthesia induction and tracheal tube or laryngeal mask intubation,Monitoring parameters included HR,interval noninvasive MBP,SPO2,PETCO2,Ppeak,Pmean.Extubation response and postoperational complications were recorded.Results HR and MBP in Group T were signi?cantly increased after intubation and extubation (P〈0.05),which were not in group P(P〉0.05).SPO2,PETCO2,Ppeak,Pmean,were similar at all the time points between the two groups(P〉0.05).Group T had higher incidence of body movement and coughing before extubation (P〈0.05).The incidence of blood cuff,sore throat and hoarse postoperatively was not significant difference between the two groups(P〉0.05).Conclusions LAM- Proseal intubation can provide the same safe and effective ventilation as tracheal intubation in gynaecological laparoscopy operation under positive pressure ventilation.LAM- Proseal is superior to tracheal intubation in intubation and extubation response,the incidence of body movement and coughing.
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