低套囊压力下ProSeal或Supreme喉罩用于腹腔镜手术患者气道管理的效果  

Efficacy of laryngeal mask airway ProSeal and Supreme under low cuff pressure in patients undergoing laparoscopic surgery

作　　者：曹江北[1] 王鹏[1] 冯雪辛[1] 米卫东[1] 张宏[1] 

机构地区：[1]解放军总医院外科临床部麻醉手术中心,北京市100853

出　　处：《中华麻醉学杂志》2010年第10期1236-1238,共3页Chinese Journal of Anesthesiology

基　　金：首都医学发展科研基金（2007-1037）

摘　　要：目的 评价低套囊压力下ProSeal和Supreme喉罩用于腹腔镜手术患者气道管理的效果.方法 择期仰卧位腹腔镜手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄20～70岁,体重50～80 kg,随机分为ProSeal喉罩组（P组）和Supreme喉罩组（S组）,每组30例.喉罩置入成功后,用手持测压计监测套囊充气压力并维持其为35 cm H2O,记录气道密闭压及气腹前后机械通气时气道压峰值和平均气道压,记录术后并发症的发生情况.结果 两组气腹后机械通气时气道压峰值高于气腹前（P＜0.05）,两组间比较差异无统计学意义（P＞0.05）;术中气腹前后均无漏气现象发生;两组气道密闭压比较差异无统计学意义（P＞0.05）;两组拔除喉罩后表面带有血丝及术后咽痛发生率比较差异无统计学意义（P＞0.05）.结论低套囊压力（35 cm H2O）下ProSeal和Supreme喉罩通气效果均较好,可安全地用于腹腔镜手术患者的气道管理.Objective To assess the efficacy of laryngeal mask airway Proseal （LMA Proseal） and Supreme （LMA Supreme） used in patients undergoing laparoscopic surgery when the cuff-pressure was 35 cm H2O.Methods Sixty ASA Ⅰ or Ⅱ patients, aged 20-70 yr, weighing 50-80 kg, undergoing elective laparoscopic surgery, were randomized into2 groups （n = 30 each）： LMA ProSeal group （group P） and LMA Supreme group （group S）. After the LMA Proseal and LMA Supreme were inserted in group P and S respectively, the cuff pressure was monitored and maintained at 35 cm H2O by manipulate manometer. The airway sealing pressure, peak and mean airway pressure before and after pneumoperitoneum during mechanical ventilation and the complications were also recorded. Results The peak airway pressure was significantly higher after pneumoperitoneum than before pneumoperitoneum during mechanical ventilation （P 〈 0.05）, but there was no significant difference in the peak airway pressure before and after pneumoperitoneum between the two groups （ P 〉 0.05）. The air leakage had never happened before or after pneumoperitoneum during mechanical ventilation. There was no significant difference in the airway sealing pressure between the two groups （ P 〉 0.05）. There was no significant difference in the incidence of throat pain between the two groups（P〉0.05）.Conclusion When the cuff pressure is 35 cm H2O, the LMA ProSeal and Supreme can provide adequate ventilation during operation with fewer complications and can be used safely for laparoscopic surgery.

关 键 词：喉面罩 呼吸 人工 腹腔镜检查 套囊压力 

分 类 号：R614[医药卫生—麻醉学]