ProSeal喉罩在颅内动脉瘤栓塞术中的临床应用  

Clinical use of ProSeal laryngeal mask airway in the embolization of intracranial aneurysms

作　　者：王松[1,2] 李娟[1,2] 康芳[1,2] 汪树东[1,2] 唐朝亮[1,2] 唐菲[1,2] 侯涛[1,2] 

机构地区：[1]安徽医科大学附属省立医院 [2]安徽省立医院南区麻醉科,合肥市230036

出　　处：《临床麻醉学杂志》2011年第12期1179-1181,共3页Journal of Clinical Anesthesiology

基　　金：安徽高校省级自然科学研究项目(KJ2009B0487)

摘　　要：目的评价ProSeal喉罩在静-吸复合麻醉颅内动脉瘤栓塞术中的临床应用效果。方法择期行颅内动脉瘤栓塞术患者40例,随机均分为喉罩组(L组)和气管插管组(T组)。麻醉诱导后,L组插入喉罩,T组给予罗库溴铵后气管插管。两组均吸入七氟醚及微量泵靶控输注丙泊酚、瑞芬太尼维持麻醉。记录麻醉诱导前(T0)、麻醉诱导后(T1)、插入喉罩或气管导管后即刻(T2)、手术结束时(T3)、拔除喉罩或气管导管即刻(T4)的SBP、DBP、HR;记录患者自主呼吸恢复时间、拔管时间以及呛咳、咽痛等并发症发生情况;记录麻醉药用量。结果 L组围术期血液动力学平稳,丙泊酚、瑞芬太尼用量较T组少(P<0.05),自主呼吸恢复时间和拔管时间明显缩短(P<0.05),咽痛发生率低。结论 ProSeal喉罩通气操作简单、刺激小、通气可靠,复合应用静-吸复合麻醉术中血流动力学平稳,术后苏醒快,且不良反应少,其效果优于气管插管。Objective To evaluate the clinical application of ProSeal laryngeal mask airway 7. （PLMA） in the embolization of intracranial aneurysms under combined intravenous and inhatational anesthesia. Methods Forty patients scheduled for interventional therapy ：of intracranial aneurysm ： were randomly divided into 2 groups （n=20 each）. After anesthesia induction, PLMA was inserted in group L without muscle relaxants while rocuronium was administered to facilitate intubation of endotracheal tube （ETT） in group T. Both groups were maintained with sevoflurane inhalation and target controlled infusion of propofol and remifentanil. SBP, DBP and HR were recorded before and after anesthesia induction, right after the insertion of PLMA or ETT, at the cessation of the procedure, and after removal of PLMA or ETT. The time for return of spontaneous breathing, the extubation time, the occurrence of adverse effects such as coughing and pharyngodynia, and anesthetic dosages used were also recorded. Results Perioperative hemodynamics was more stable, consumption of propofol and remifentanil was less, emergence from anesthesia was faster, and occurrence of pharyngodynia was fewer in group L than that in group T（P〈0.05）. Conclusion PLMA is superior to endotracheal intubation in the embolization of intracranial aneurysms in terms of easy placement, reliable ventilation, less irritation, better hemodynamic profiles, faster emergence and less adverse effects.

关 键 词：PROSEAL喉罩 气管插管 颅内动脉瘤栓塞术 

分 类 号：R614[医药卫生—麻醉学]