喉罩通气应用于小儿全身麻醉的临床观察  

Laryngeal Mask Airway for General Anesthesia in Children: a Clinical Observation

作　　者：付学明[1] 安振平[1] 熊伟[1] 左星[1] 蒋思源[1] 万娇娇[1] 

机构地区：[1]湖北省孝感市中心医院麻醉科,432100

出　　处：《中华全科医学》2013年第10期1538-1539,共2页Chinese Journal of General Practice

摘　　要：目的探讨喉罩通气应用于小儿全身麻醉的可行性和安全性。方法选择80例择期手术患儿,随机分为喉罩组(L组)和静脉全麻组(M组),每组40例。两组患儿均采用面罩吸入6%七氟醚麻醉诱导,然后静脉注射咪唑安定0.05 mg/kg、芬太尼4μg/kg、静脉泵注异丙酚4 mg/(kg·h),L组在手术开始前放置喉罩通气,M组经麻醉机面罩通气给氧,两组患儿在术中均持续吸入1%~2%七氟烷,手术结束前3 min停止给予异丙酚和七氟醚。记录麻醉前T0,麻醉5分钟T1,麻醉20分钟T2,手术结束T3各时点的MAP、SPO2、HR,记录术中患儿躁动,呼吸道梗阻,误吸的发生情况以及两组患者手术时间和清醒时间。结果 L组苏醒时间短于M组,呼吸道梗阻M组明显高于L组。L组与M组比较,T0、T2、T3各时点的HR、SPO2、MAP之间比较差异均无统计学意义,T1时HR、SPO2、MAP组间比较差异均存在统计学意义。结论小儿全麻下使用喉罩通气的麻醉方法具有操作简单,血流动力学平稳,没有呼吸系统并发症,是一种值得推广的小儿麻醉方法。Objective To study the effect and safety of laryngeal mask airway （LMA） on general anesthesia in children. Methods A total of 80 Children undergoing elective operation scheduled were randomized to LMP（L） group and Intravenous anesthesia （M） group with 40 cases each. Both groups received mask anesthesia induction with 6% sevoflurane, followed by intra- venous midazolam 0.05 mg/kg and fentanyl 4 I^g/kg, and intravenous infusion of propofol 4 mg/kg, h. The ventilation was per- formed with LMA in the group L and anesthesia machine in group M before the start of surgery. Both groups were administrated with continuous sevoflurane. Propofol and sevoflurane were canceled 3 minutes before the end of operation. MAP, HR and SpO2 on TO （pre-anesthesia）, T~ （5 minutes after the beginning of anesthesia）, T~ （20 minutes after the beginning of anesthesia） and T3 （ end of the operation） were recorded. The incidences of postoperative agitation, airway obstruction and aspiration were recorded. The operation time and recovery times were observed. Results The recovery times of Group L was shorter than that in group M. The incidence of airway obstruction in group M was higher than that in group L. There was no difference in the levels of MAP, HR and spo2 on To ,T2 ,T3 ;but the difference in MAP,HR and SpO2 on T1 was statistical significant. Conclusion Laryngeal mask airway for general anesthesia is safe and easy. It can keep a stable hemodynamics and low incidence of complications.

关 键 词：喉罩 小儿 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]