腹腔镜胆囊切除术全麻期间双管喉罩与气管导管的应用比较  

Application comparison between Endotracheal tube and LMA-ProSeal undergoing laparoscopic cholecystectomy during general anaesthesia

作　　者：张双菊[1] 肖维[1] 江春秀[1] 

机构地区：[1]重庆市第三人民医院麻醉科,400014

出　　处：《重庆医学》2010年第20期2748-2750,共3页Chongqing medicine

摘　　要：目的比较双管喉罩及气管插管对青壮年七氟醚全麻腹腔镜下胆囊摘除术的影响。方法选择30例ASAⅠ-Ⅱ级无禁忌证的腹腔镜胆囊摘除术患者,18-54岁青壮年患者接受双管喉罩与气管插管对比及一定七氟醚浓度的麻醉方案,采用随机数字法分为双管喉罩组（P组）、气管插管组（E组）,喉罩组常规放置胃管。测量心率、血压、脉搏血氧饱和度、呼气末七氟醚浓度、呼气末二氧化碳分压,记录麻醉中用药量等。结果 E组在插管后2、5 min收缩压高于P组（P〈0.01及P〈0.05）,2 min时舒张压也高于P组（P〈0.05）,在插管后2、5 min,切皮时心率高于P组（P〈0.05）。P组阿曲库铵等用药量明显低于E组（P〈0.01）。结论吸入一定浓度七氟醚,常规安置胃管的双管喉罩全麻,术中循环稳定、气道安全,用药量明显减少,为临床麻醉较佳方案。Objective To compare effect of LMA-ProSeal with that of tracheal intubation on young adults undergoing laparoscopic cholecystectomy under general anesthesia with sevoflurane.Methods Thirty ASA Ⅰ-Ⅱ patients,who had no contraindications for intubation and placement of LMA-ProSeal,undergoing elected laparoscopic cholecystectomy under general anesthesia with certain concentration of sevoflurane were randomly assigned into 2 groups of P（ProSeal laryngeal mask） and E（endotracheal tube） with 15 cases each（age 18-54 years）.Gastric tubes were placed for group P.Measurement：HR,BP,SPO2,End-Tidal Concentration of sevoflurane,End-Tidal Pressure of CO2 and dosage of drugs for anesthesia.Results SBP of group E was apparently higher than group P at 2,5 min after intubated（P〈0.01 and P〈0.05 respectively）.DBP was also higher than that at 2 min（P〈0.05）.HR of group E was obviously higher than that of group P at 2,5 min after intubated and skin incision（P〈0.05）.There were remarkable lower dosages of anesthetics（such as atracurium,fentanyl,propofol） in group P（P〈0.01）.Conclusion Application of inhalating certain concentrations of sevoflurane for young adults and routinely placing gastric tubes for them with LMA-ProSeal under anesthesia is a better formula of clinical anesthesia for surgery to keep stabile circulation,airway security and to reduce the anesthetic dosages.

关 键 词：双管喉罩 气管导管 腹腔镜胆囊切除术 全麻 

分 类 号：R614.2[医药卫生—麻醉学] R616.6[医药卫生—外科学]