Supreme喉罩和气管插管在全身麻醉应用中的对比研究  

Comparative study of laryngeal mask airway Supreme and tracheal intubation applicated in general anesthesia

作　　者：蒋燕[1] 龙勤[1] 雷晓峰[1] 唐延先[1] 魏闯[1] 

机构地区：[1]重庆市肿瘤研究所麻醉科,400030

出　　处：《重庆医学》2012年第29期3061-3063,共3页Chongqing medicine

摘　　要：目的比较Supreme与气管插管对围术期血流动力学及并发症的影响。方法选取年龄35～60岁,ASA分级为Ⅰ～Ⅱ级,拟在全身麻醉下行乳癌根治术的患者50例,随机分为Supreme组(S组,n=25)和气管插管组(T组,n=25)。观察Su-preme喉罩试插次数、对位程度、气道峰压,记录麻醉诱导前后、置入喉罩或插入气管导管即刻、插入后1、3、5min、拔管前即刻及拔管后1、3、5min的心率和血压,并观察术后24h内是否发生咽喉疼痛、吞咽异物感和声嘶。结果 Supreme喉罩一次性置入成功率为92%,且对位程度均较好,二氧化碳分压维持在正常范围。与T组比较,S组气道压明显下降。与诱导前基础值比较,两组诱导后心血管指标均明显下降(P<0.05)。T组插管即刻、插管后1、3min、拔管前即刻和拔管后1、3、5min的指标较基础值显著升高(P<0.05)。S组插管后3、5min血压较诱导后水平显著降低(P<0.05),拔出前即刻和拔后1、3、5min的指标与基础值比较差异无统计学意义。与S组比较,T组插管即刻、拔管前即刻、插管后和拔管后1、3、5min的指标均明显升高,其他时间点各指标两组间比较差异均无统计学意义(P>0.05)。与T组比较,S组气道并发症明显降低(P<0.05)。结论 Supreme喉罩置入一次性成功率较高,可减轻围术期心血管应激反应,降低气道并发症,提高患者全身麻醉后的舒适度。Objective To investigate the effects of Supreme LMA application and endotracheal intubation on hemodynamics during induction of or emergency from general anesthesia and postoperative complications. Methods Fifty patients of 35-- 60 years old, ASA physical status I -- II , scheduled for selective modified radical masteetomy under general anesthesia were randomly divid- ed into Supreme（S,n=25） and tracheal intubation（T ,n= 25） groups. The attempts of intubation,airway pressure,systolic or diastolic arterial pressure,and heart rate（HR） were recorded during the induction of or emergency from general anesthesia. Then sore throat,dysphagia and trachyphonia were observed within 24 h postoperatively. Results The success rate of the first attempt insertion of Supreme was 92 %. Compared with group T, airway pressure was significantly decreased in group S（P〈 0.05）. Compared with basal value, systolic and diastolic pressures and heart rate were significantly increased during intubation and extubation in group T,which were also much higher than those in group S（P〈0.05）. The incidence of pharyngolaryngeal adverse events after extubation within 24 h were significantly decreased in group S than that in group T（P〈0.05）. Conclusion Insertion Supreme LMA can be easily managed,induces less hemodynamic changes,and can improve patients comfort after general anesthesia.

关 键 词：喉面罩 插管法 气管内 心血管反应 并发症 

分 类 号：R614[医药卫生—麻醉学]