双管喉罩在主动脉夹层动脉瘤介入手术麻醉中的应用  

Application of proseal laryngeal mask airway in the anesthesia of interventional therapy for tho- racic aortic dissecting aneurysm

作　　者：李明勇[1] 巩继平[1] 

机构地区：[1]河南省新乡市中心医院麻醉科,453000

出　　处：《中国实用医刊》2013年第16期16-18,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨双管喉罩全麻在胸主动脉夹层动脉瘤介入治疗中的临床应用效果。方法选择择期行覆膜支架介入治疗胸主动脉夹层动脉瘤患者40例，ASAII～III级。将其随机分为气管插管全麻组（ET组）和双管型喉罩全麻组（PLMA组），每组各20例。观察两组各时点血流动力学、脉搏血氧饱和度（SpO2）、术毕清醒拔管时间、术中麻醉药及降压药用量、麻醉相关并发症。结果患者的收缩压（SBP）、平均动脉压（MAP）和心率（HR），在插管前（T2）ET组显著低于PLMA组（P〈0．05），在气管插管即刻（T3）、拔管即刻（T5）两个时点ET组显著高于PLMA组（P〈0．05）。PLMA组患者麻醉诱导及术中维持所需麻醉药量均较ET组少（P〈0．05），PLMA组硝普钠用量显著少于ET组（P〈0．05），PLMA组患者术后清醒恢复快（P〈0．05），两组患者术中及术后未发生麻醉相关并发症。结论双管型喉罩全麻用于覆膜支架介入治疗胸主动脉夹层动脉瘤效果良好，麻醉的可控性大大增加，麻醉风险降低，较传统气管插管麻醉方式有很大的优势，是一种值得临床推广应用的方法。Objective To investigate the clinical application effect of proseal laryngeal mask on anesthesia of interventional therapy for thoracic aortic dissecting aneurysm. Methods Forty patients with thoracic aortic dissection aneurysm underwent endovascular stent graft repair, ASA II -III, were ran- domly divided into endotracheal intubation anesthesia group （group ET） and proseal laryngeal mask anes- thesia group（ group PLMA） , with 20 cases in each group. During operation, the hemodynamics, pulse oxygen saturation （SpO2 ）, drug dosage, recovery and extubation time, anesthesia related complications of patients were observed. Results At before intubation （T2） , the SBP, MAP and HR of patients in group ET were significantly lower than those in group PLMA （ P 〈 0.05 ）. At endotracheal intubation immediate （ T3 ） and extubation immediate （ T5 ） time, the SBP, MAP and HR of patients in group ET were signifi- cantly higher than those in group PLMA （ P 〈 0.05 ）. Anesthetics dosage of anesthesia induction and an- esthetics dosage of maintenance of anesthesia in group PLMA were fewer than those in group ET （ P 〈 0. 05 ）. Sodium nitroprusside dosage of patients in group PLMA were significantly less than that in group ET（ P 〈0. 05）. The patients in group PLMA awaked more rapidly（ P 〈 0. 05）. During intraoperative and postoperative periods, complications associated with anesthesia had not occurre in the two groups. Conclusions The effect of proseal laryngeal mask anesthesia on endovascular stent graft repair of thorac- ic aortic dissecting aneurysm is good, the anesthetic controllability increases greatly, the anesthetic risk is lowered. Compared with traditional endotracheal intubation anesthesia, proseal laryngeal mask anesthesia has a lot of advantages, is worthy to be popularized in clinics.

关 键 词：双管喉罩 胸主动脉夹层动脉瘤 介入治疗 

分 类 号：R614[医药卫生—麻醉学]