鼻内窥镜手术患者可弯曲喉罩与一次性双管喉罩气道管理效果比较  

Comparsion of efficiency between flexible laryngeal mask airway and supreme laryngeal mask airway in patients undergoing nasal endoscopic surgery

作　　者：许航[1] 刘环秋[1] 李飞[1] 宋晓[1] 麻海春[1] 冯艳华[1] 

机构地区：[1]吉林大学白求恩第一医院麻醉科,长春130021

出　　处：《国际麻醉学与复苏杂志》2013年第4期296-299,共4页International Journal of Anesthesiology and Resuscitation

基　　金：基金项目：国家自然科学基金（200505226）

摘　　要：目的观察可弯曲喉罩（flexible laryngeal mask airway，FLMA）与一次性双管喉罩（supreme laryngeal mask airway，SLMA）在鼻内窥镜手术中的气道管理效果，并对二者进行比较。方法选取择期行鼻内窥镜手术患者40例。美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级、年龄20岁～70岁、体重指数〈30kg／m^2。按随机数字表法随机分成两组，分别为FLMA组（F组）及SLMA组（S组），每组各20例。记录麻醉时间、手术时间、喉罩拔除时间（术毕至呼吸恢复正常可以拔除喉罩的时间）和苏醒时间（术毕至呼之睁眼的时间）；术毕即刻、术后6、24、36h咽喉疼痛发生情况；术者满意程度。统计学分析处理采用SPSS19．0软件完成。结果①两组喉罩首次成功率分别为95％、90％，差异无统计学意义（P〉0．05）。②F组置入时间（10．2±1．8）s，S组置入时间（6．3±1．3）s，差异有统计学意义（P（0．05）。③气道压、气道密封压、纤维支气管镜（branchofiberoscope，FOB）检查分级、两组术后拔出喉罩即刻咽喉疼痛发生例数、术后6h咽喉疼痛发生例数差异无统计学意义（P〉0．05）。④两组之间手术医生的满意度差异无统计学意义（P〉0．05），但是F组有一个上升的趋势。结论①FLMA与SLMA均可应用于全身麻醉下鼻内窥镜手术的气道管理，安全可靠。SLMA比FLMA更易置入。②FLMA可适用于各类鼻内镜手术，SLMA在涉及到额窦的手术时应用受到一定限制。Objective To observe the Efficacy of flexible laryngeal mask airway（FLMA） and supreme laryngeal mask airway （SLMA） in nasal endoscopic surgery. Methods 40 patients aged 20-70 and ASA Ⅰ-Ⅱ, the patients are randomly divided into two groups, FLMA group （F group） and SLMA group （S group）. The rate of LMA successful placement, LMA placement time, fibereptic bronchoscope grade, airway sealing pressure, airway pressure, air leakage during operation, complication, the length of anesthesia time, duration of surgery, extubation time , emergence time and the satisfication of surgeons was recorded. Results The successful placement at first time was 95% ,90% respectively. The time of placement in S group was shorter than that in F group [ （6.3±1.3） s vs （10.2±1.8） s, P〈0.05 ]. The differences of fiberoptic bronchoscope grade, airway sealing pressure, airway pressure, air leakage during operation, complication between two groups have no statistical significance （P〉0.05）. There was no statistical significance between two groups in surgeon＇s satisfaction. Conclusions Both FLMA and SLMA were safe for nasal endoscopic surgery, and the placement of SLMA was much easier. FLMA may be a better choice in nasal endoscopic surgery without frontal sinus.

关 键 词：鼻内窥镜外科 可弯曲喉罩 一次性双管喉罩 

分 类 号：R614[医药卫生—麻醉学]