喉罩通气静脉全麻在小儿腹腔镜隐睾手术中的应用  

Application of laryngeal mask airway intravenous anesthesia in laparoscopic surgery for undescended testis in children

作　　者：陈龙水[1] 彭皓琰[1] 杜少芬[2] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,广东汕头515041 [2]汕头大学医学院附属肿瘤医院麻醉科

出　　处：《中国校医》2012年第6期454-456,共3页Chinese Journal of School Doctor

摘　　要：目的探讨喉罩通气(LMA)在小儿腹腔镜隐睾手术中的应用,并与气管内插管通气(TT)同类手术比较。方法选择腹腔镜小儿隐睾手术120例,随机分为两组,即喉罩组(LMA组)60例和气管插管组(TT组)60例,入室前静脉慢推丙泊芬1～3 mg/kg让患儿安静再入室。全麻诱导维持采用静脉TCI泵分别泵注维持靶控血浆浓度:瑞芬太尼3.5μg/kg/min和丙泊芬(静安)3.5μg/kg/min,并单次静脉注射顺苯阿曲库铵0.1 mg/kg,每45 min可以追加一次。诱导后插入喉罩或气管导管。观察两组患儿在诱导前和LMA(TT)置入前、后及拔除前后的收缩压(sBP)、舒张压(DBP)、心率(HR)的数值,观察监测术中脉搏血氧饱和度(SPO2)、呼气末二氧化碳分压(PETCO2)的变化,并对苏醒情况及气道并发症进行比较。结果 LMA组在置入前后的HR、BP差异无统计学意义(P>0.05);TT组在插管前后的HR、BP差异有统计学意义(P<0.05);2组的气道压力、SPO2、PETCO2比较差异无统计学意义(P>0.05);2组在苏醒时间、气道并发症方面比较,LMA组要优于TT组。结论喉罩通气用于小儿腹腔镜隐睾手术对循环无明显影响,置入简便,通气满意,对气道损伤小,不良反应少,苏醒较快,安全可靠。在小儿麻醉中值得推广。Objective To explore the application of laryngeal mask airway（LMA） in laparoscopic surgery for undescended testis in children,compared with endotracheal ventilation（TT） of similar operations.Methods Totally 120 cases of laparoscopic surgery for cryptorchidism were randomly divided into 2 groups： a laryngeal mask airway（LMA） group and an endotracheal intubation（TT） group.The routine intravenous anesthesia was performed in both groups and after inducing,laryngeal mask airway or endotracheal tube was applied in the LMA group or the TT group.The systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,SPO2,and PETCO2 were observed.Results In the LMA group,there were no significant differences of HR and BP before and after placing LMA,but there were significant differences of HR and BP in the TT group before and after the intubation.In airway pressure,SPO2,and PETCO2,there were no significant differences between the two groups.The analepsia time and airway complications in the LMA group were better than those in the TT group.Conclusions Laryngeal mask airway applied in laparoscopic cryptorchidism surgery in children has no obvious effect on circulation,and it is simple,and it also has a satisfaction in ventilation,fewer airway injury,fewer adverse reactions,and the analepsia is fast,so it is safe and reliable.

关 键 词：儿童 隐睾/外科手术 麻醉 全身/方法 喉面罩 

分 类 号：R726[医药卫生—儿科]