经喉罩通气全凭静脉全麻用于小儿四肢手术的临床研究  

Clinical research on laryngeal mask airway with general anesthesia in pediatric limb operation

作　　者：杨焕杰[1] 杨少春[1] 黄伟[1] 梁华[1] 

机构地区：[1]解放军第五医院,宁夏银川750004

出　　处：《实用临床医药杂志》2012年第3期95-96,98,共3页Journal of Clinical Medicine in Practice

摘　　要：目的研究对比经喉罩/气管插管通气在小儿全凭静脉全麻中的效果及安全性。方法选择40例ASAⅠ、Ⅱ级患儿随机分为2组:气管内插管全凭静脉全麻(A组);喉罩通气全凭静脉全麻(B组),每组20例。监测记录麻醉前(T0)、置入喉罩/气管导管时(T1)、切皮(T2)、术毕(T3)、拔除喉罩/气管导管时(T4)的MAP、HR、SpO2、PETCO2。术毕计算麻醉药总量,记录手术结束到拔除喉罩/气管导管时间,观察患儿是否有喉痉挛、舌后坠、术后躁动等并发症的发生。结果两组患儿年龄、性别、体重、手术时间比较无显著性差异(P>0.05);与麻醉前比较,MAP、HR,A组在T1、T4即刻有显著性差异(P<0.05,P<0.01),B组无显著性差异(P>0.05);与A组比较,MAP、HR,在T1、T4即刻有显著性差异(P<0.05,P<0.01)。SpO2、PETCO2在各时间点无显著性差异(P>0.05)。手术结束拔除气管导管与喉罩时间比较无显著性差异(P>0.05);喉痉挛、术后躁动两组有显著性差异(P<0.01)。两组全麻药用量无显著性差异(P>0.05)。结论经喉罩通气全凭静脉全麻具有刺激小,血流动力学平稳且并发症少等优点,可安全有效的应用于小儿四肢手术麻醉。Objective To study the effect and safety of laryngeal mask/tracheal intubation airway with general anesthesia in pediatric limb operation.Methods Forty patients with pediatric limb disease（ASA I-Ⅱ） who was going to undergo limb operation were randomly divided into group A with tracheal intubation airway and group B with laryngeal mask airway.Pre-anesthesia（T0）,insertion of laryngeal mask and tracheal intubation（T1）,incising（T2）,completed operation time（T3）,pulling out laryngeal mask and tracheal intubation（T4）,MAP,HR,SpO2 and PETCO2 were monitored.The amount of anesthetic was calculated,the time of T3 to T4 was recorded,and such complications as laryngospasm,glossocoma and restlessness were observed.Results There were no significant differences in age,gender,weight and time of operation between two groups（P〉0.05）.Compared with conditions before operation,MAP and HR at T1 and T4 in group A were significantly different（P〈0.05,P〈0.01） while group B had no significant difference（P〉0.05）.Compared with group A,MAP and HR at T1 and T4 were significantly different（P〈0.05,P〈0.01）.There were no significant differences in SpO2,PETCO2 at each time point（P〉0.05）.There were significant differences in laryngospasm and restlessness（P〉0.05）.There were no significant differences in amount of anesthetic（P〉0.05）.Conclusion Laryngeal mask airway with general anesthesia has less side effects,stable hemodynamics and less complications.It proves to be safe and effective in pediatric limb operation.

关 键 词：喉罩 小儿手术 全凭静脉麻醉 

分 类 号：R614.24[医药卫生—麻醉学]