复合全麻联用双管喉罩于脑动脉瘤栓塞术的麻醉效果  

The Effect of Combination of Inhalational Combined Intravenous Anesthesia and Proseal Larnygeal Mask Airway in Endovascular Treatment of Intracranial Aneurysms

作　　者：田丰[1] 何卓文[1] 冯秀芬[1] 赖梅[1] 

机构地区：[1]广东省肇庆市第一人民医院麻醉科,526021

出　　处：《中华全科医学》2011年第3期382-383,共2页Chinese Journal of General Practice

摘　　要：目的介绍静吸复合麻联合食管引流型喉罩方法在颅内动脉瘤栓塞术(介入)中的优越性。方法把需行颅内动脉瘤栓塞术的40例患者分为两组:食管引流型喉罩组(A组)和气管插管组(B组)。两组麻醉用药相同:按公斤体重分别注射丙泊酚、芬太尼和顺苯磺酸阿曲库铵静脉诱导,置管后机控呼吸并吸入七氟醚和持续静注丙泊酚维持至手术结束。记录两组患者诱导前后、置入喉罩或导管后1 min、3 min、5 min,拔出喉罩或导管前及后5 min的SBP、DBP和HR值及麻醉并发症等。结果置入喉罩或导管后1 min、3 min的BP及拔出喉罩或导管前后的BP、HR组间比较差异均有统计学意义(P<0.05),B组均高于A组;B组在整个麻醉过程中发生躁动、呛咳、支气管痉挛及喉痉挛、口腔血肿等麻醉并发症的较多。结论颅内动脉瘤栓塞术麻醉运用静吸复合麻联合使用食管引流型喉罩一法是最佳的麻醉搭配。Objective To investigate the effect of combination of inhalational combined intravenous anesthesia and proseal larnygeal mask airway in endovascular treatment of intracranial aneurysms. Methods 40 patients were randomly divided into 2 groups：prosed larnygeal mask airway group （group A ）and tracheal intubation group（ group B ）. Two sets of anaesthesia were per- formed according to the body weight with Propofol, Fentanyl and Cisatracurium Besilate veinous revulsion, Sevoflurane wasinhaled and Propofol was injected veinously until the finishing of the operation. SBP, DBP, HR and complications before and after veinous revulsion, 1 min,3 min and 5 min, before and after pulling out larynx cover or tube were recorded. Results The differences of BP after 1 min,3 min of putting larynx cover or tube, the differences of BP and HR after pulling out larynx cover or tube were all sta- tistically significant（P 〈 0.05 ）. There were more complications such as restless, bucking incidence, bronehospasm laryngospasm and oral cavityhematoma occurred in group B. Conclusion The effect of combination of inhalational combined intravenous anesthesia and proseal larnygeal mask airway in endovascular treatment of intracranial aneurvsms was good.

关 键 词：喉罩 丙泊酚 七氟醚 颅内动脉瘤栓塞术 

分 类 号：R614.1[医药卫生—麻醉学] R732.21[医药卫生—外科学]