经ProSeal喉罩吸入七氟醚全麻在腹腔镜手术中的临床应用  

Clinical Application of Laryngeal Mask Airway ProSeal Inhalation of Sevoflurane Anesthesia in Gynecologic Laparoscopy

作　　者：廖永强[1] 李荣胜[1] 韩琪[1] 谢华杰[1] 蓝晓文[1] 周德清[1] 王彩霞[1] 

机构地区：[1]广东省东莞市人民医院麻醉科,广东东莞523059

出　　处：《临床医学工程》2012年第10期1693-1694,共2页Clinical Medicine & Engineering

基　　金：东莞市医疗卫生科技计划一般项目(201010515000069)

摘　　要：目的探讨妇科腹腔镜手术时经ProSeal喉罩(PLMA)吸入七氟醚的临床麻醉和通气效果。方法 40例择期妇科腹腔镜手术患者,随机分为气管导管组(ET组)和PLMA组(PL组),每组20例。全麻诱导依次静注芬太尼4μg/kg、丙泊酚2～2.5mg/kg、阿曲库铵0.6mg/kg。分别置入气管导管(ET组)或PLMA(PL组),行容量控制呼吸。麻醉维持为吸入七氟醚0.9～1.2MAC,持续输注瑞芬太尼0.1～0.2μg·kg-1·min-1,间注阿曲库铵0.25mg/kg。结果两组患者全麻诱导期SBP、DBP及HR均下降(P<0.01);在气管插管或置入PLMA后,ET组SBP、DBP、HR均明显较PL组高(P<0.05或P<0.01);PL组Cp在机械通气期间显著高于ET组(P<0.01);PL组术后咽喉痛、声嘶患者少于ET组。结论 PLMA可以安全有效地应用于腹腔镜手术全麻中通气,相比于气管插管,本方法可减少气管插管常并发的气管、咽喉损伤,术中血流动力学更平稳,苏醒质量更佳。Objective To compare clinical efficacy between laryngeal mask airway ProSeal （PLMA） and endotrachial tube under sevoflurane anesthesia during gynecologic laparoscopy. Methods 40 ASA physical status I and II patients undergoing gynecologic laparoscopic surgery were divided randomly into group PL and group ET, to receive PLMA and endotracheal tube repectively for airway management. SBP, DBP and HR were monitored and complications were recorded. Results SBP, DBP and HR decreased in induction period of anesthesia in two groups （P 〈0.01）. And after insertion of PLMA, the hemodynarnics were maintained stable in group PL, as those in group ET increased significantly （P 〈0.05 or P 〈0.01）. During positive pressure ventilation the compliance in group PL was higher than that in group ET （P 〈0.01）. Smaller numbers of mucosal injury and sore throat were found in group PL than in group ET （P 〉0.05）, whereas there were no significances between two groups. Conclusions PLMA may be safely and effectively used in gynecologic laparoscopic surgery, with more stable hemodynamics and fewer incidences of mucosal injury and sore throat compared with endotracheal tube.

关 键 词：妇科 腹腔镜手术 喉罩 气管插管 七氟醚 

分 类 号：R614.21[医药卫生—麻醉学]