双腔喉罩可安全应用于小儿腹腔镜手术  

ProSeal laryngeal mask airway can be applied safely in pediatric laparoscopic surgery

作　　者：詹玮玮[1] 胡阳[1] 高昌健[1] 彭红兵[1] 吴柳春[1] 

机构地区：[1]葛洲坝中心医院麻醉科,湖北宜昌443002

出　　处：《上海医学》2013年第8期699-701,共3页Shanghai Medical Journal

摘　　要：目的观察小儿双腔喉罩应用于小儿腹腔镜手术的可靠性和安全性。方法选择择期行小儿腹腔镜手术的患儿60例,随机分入双腔喉罩组和气管插管组,每组30例。分别记录麻醉前(T1)、置入喉罩或气管导管前(T2)、置入喉罩或气管导管即刻(T3)、置入喉罩或气管导管后5min(T4)、拔除喉罩或气管导管前(T5)、拔除喉罩或气管导管即刻(T6)各时间点,患儿的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(Sp O2)、呼气末二氧化碳分压(petCO2),并记录术后并发症的发生情况。结果两组均成功置入双腔喉罩或气管导管,双腔喉罩组1次置罩成功率为80.0%(24/30),气管插管组1次插管成功率为100%(30/30)。双腔喉罩组在T3时间点的HR、MAP和T6时间点的MAP均显著低于气管插管组同时间点(P值均<0.01),两组间其他各时间点的HR、MAP的差异均无统计学意义(P值均>0.05)。气管插管组在T3、T6时间点的HR和MAP均显著高于同组T1、T2、T4、T5时间点(P值均<0.05)。两组间各时间点的Sp O2和petCO2的差异均无统计学意义(P值均>0.05)。双腔喉罩组术后并发症发生率为20.0%(6/30),显著低于气管插管组的80.0%(24/30);其中苏醒期躁动、咽部不适和术后声嘶的发生率分别为6.7%(2/30)、6.7%(2/30)和0,均显著低于气管插管组的26.7%(8/30)、36.7%(11/30)和10.0%(3/30,P值均<0.05)。结论双腔喉罩的操作简便,患儿产生的应激反应小,并发症少,且无二氧化碳蓄积,应用于小儿腹腔镜手术安全可靠。Objective To evaluate the safety and efficacy of ProSeal laryngeal mask airway （PLMA） during pediatric laparoscopic operation. Methods Sixty pediatric patients scheduled for elective laparoscopic operation were randomly divided into PLMA group and tracheal intubation group （n = 30）. Heart rate （HR）, mean arterial pressure （MAP）, pulse oxygen saturation （SPO2）, and end tidal carbon dioxide partial pressure （PetO02） were recorded before anesthesia （T1）, before inserting PLMA or endotracheal catheter （T2）, when PLMA or tracheal catheter was inserted （T3）, at 5 min after insertion of PLMA or endotracheal tube （T4）, before extubation or removing PLMA （Ts）, and when PLMA or endotracheal tube was removed （T6）. Postoperative complications were observed. Results PLMA or endotracheal tube were successfully inserted in all patients. The first-time success rate of insertion was 80.0% （24/30） in PLMA group and 100.0% （30/30） in endotracheal intubation group. HR and MAP at T3 and MAP at ＂I＂6 in PLMA group were significantly lower than those in endotracheal intubation group （all P^0.01）. There were no significant differences in HR or MAP at other time points between two groups （all P~ 0.05）. In endotracheal intubation group, HR and MAP at T3 and T6 were significantly higher than that at T1, T2, T4 and T5 （all P〈0.05）. There were no significant differences in SpO2 or petCO2 between two groups （all P〉 0.05）. The incidence of postoperative complications was 20.0% （6/30） in PLMA group and 80.0% （24/30） in endotracheal intubation group. The incidences of emergence agitation, hoarseness and throat discomfort were all 6.7% in PLMA group, which were significantly lower than those in endotracheal intubation group （26.7%, 36.7% and 10%, all P〈0.05）. Conclusion PLMA has the advantages of simple operation, small stress responses, fewer complications, and no carbon dioxide accumulation. So it is safe and reliable in pediatric laparoscopic operation

关 键 词：双腔喉罩 气管插管 小儿 腹腔镜手术 

分 类 号：R726.1[医药卫生—儿科]