小儿无肌松药喉罩置入在腹腔镜下斜疝高位结扎术的应用  

Clinical application of laryngeal mask insertion without use of muscle relaxants on laparoscopic high ligation of hernial sac in children

作　　者：林慧芯[1] 陈杰文[1] 陈聪[1] 梁秀兰[1] 

机构地区：[1]广东省江门市中心医院麻醉科,广东江门529030

出　　处：《中国现代医生》2013年第4期93-94,共2页China Modern Doctor

摘　　要：目的观察小儿腹腔镜下高位结扎术施行无肌松药喉罩置入的可行性。方法将60例择期行腹腔镜下斜疝高位结扎术患儿随机分为无肌松药组(A组)和肌松药组(B组),各30例。观察两组患儿插入喉罩可行性、血流动力学变化、术中体动、自主呼吸恢复时间、拔喉罩时间、恢复室留观时间、苏醒时间。结果 A组患儿和B组患儿均能顺利置入喉罩,无呛咳、体动、不良反射,A组置入喉罩后血流动力学比B组稳定(P<0.01),两组患儿术中均无体动,A组患儿苏醒时间、自主呼吸恢复时间、拔喉罩时间、麻醉恢复时间均少于B组(P<0.01)。结论无肌松药瑞芬太尼复合异丙酚静脉麻醉在小儿腹腔镜下斜疝高位结扎术可获得稳定血流动力学,且术后自主呼吸恢复快,拔喉罩时间短,而不致患儿苏醒延迟。Objective To investigate the feasibility effect of laryngeal mask insertion without use of muscle relaxants on laparoscopic high ligation of hernial sac in children. Methods All 60 cases of peadiatrics with ASA （American Society of Anesthesiologists） status undergoing selective laparoscopic high ligation of hernial sac were randomly divided into two groups such as without use of muscle relaxants groups （group A） and muscle relaxants group （groups B）, each of 30 cases. Observed and recorded the feasibility of laryngeal mask insertion, the change of hemodynamics, body movement intraoperation, the recovery time of spontaneous respiratory, pull room time and observing time. Results Laryngeal and there were no cough and body movement was more stability than group B （P 〈 0.01）, spontaneous breathing recovery, pull laryngeal laryngeal mask time, anesthesia recovery mask airway insertion were performed successfully in two groups, during laryngeal mask airway insertion. The hemodynamics in group A and there were no body movement in both groups. The time of awake, mask time and the anesthesia recovery time in group A were less than in group B （P 〈 0.01 ）. Conclusion Laryngeal mask insertion without use of muscle relaxants on laparoscopic high ligation of hernial sac in children intravenous anesthesia with remifentanil-propofol can provide clinically acceptable laryngeal mask and stable hemodynamic and quick and smooth recovery of the patients, and the recovery of sponta- neous breathing time is shorter,without delay to children.

关 键 词：瑞芬太尼 喉罩 无肌松药 

分 类 号：R614[医药卫生—麻醉学]