i-gel喉罩在老年患者泌尿外科腔镜手术中的应用  

Application of i-gel laryngeal mask airway ventilation in urologic laparoscopy surgery of elderly patients

作　　者：张艳华[1] 周玉弟[1] 张杰[1] 郭杰[1] 秦勤[1] 郑曼[1] 

机构地区：[1]南京中医药大学附属江苏省中医院麻醉科,210029

出　　处：《临床麻醉学杂志》2013年第12期1196-1198,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察i-gel喉罩用于老年患者泌尿外科腔镜手术的临床效果。方法择期泌尿外科腔镜手术老年患者40例，年龄65-78岁，ASAI～Ⅲ级，随机分为i-geI喉罩组（I组）和气管插管组（E组）。记录插管（喉罩）前5min（T1）、插管（喉罩）后1min（T2）、拔管（喉罩）前1min（T3）及拔管（喉罩）后1min（T4）的MAP和HR，记录术中PnCO2、SpO2和气道峰压（Ppeak），监测麻醉后1h内动脉血气。记录拔管（喉罩）时间，记录术后呛咳躁动、咽喉痛、声嘶等不良反应情况。结果与T1时比较，T2时E组MAP明显升高，HR明显增快（P〈0．05）。与T3时比较，T4时E组MAP明显升高，HR明显增快（P〈0．05）。与I组比较，T2、T4时E组MAP明显升高，HR明显增快（P〈0．05）。I组拔出喉罩时间（15．6±1．2）min，明显短于E组的（28．3±1．1）min（P〈0．05）。E组术后呛咳躁动明显多于I组（P〈0．05）。结论全麻i-gel喉罩通气在老年患者泌尿外科腔镜手术中优于气管插管，更易于维持血流动力学稳定，减少对呼吸道损伤，有利于呼吸功能保护，缩短了拔管时间。患者术后并发症少，更安全舒适地度过围术期。Objective To observe the safety and efficacy of i-gel laryngeal mask airway used in urologic laparoscopy surgery of elderly patients. Methods Forty patients, ASA I -III, undergoing the urologic laparoscopy surgery, were randomized into two groups： i gel laryngeal mask airway group（group I）and tracheal tube group（group E）. The HR, interval noninvasive MAP of 5 minutes before and after intubation or extubation were monitored. The Pro-CO2, SpO2 ,Ppeak, 60 minutes after insertion as well as complications were recorded. Results The MAP and HR of group I after intubation and extubation were less than those in group E（P〈0.01）. The MAP and HR of group I after intubation and extubation were similar with those before. The MAP and HR of group E after intubation and extubation were more than those before（P〈0.01）. The PET CO2, SpO2, Ppeak, 60 minutes after insertion were similar between the two groups. Complications in group I were less than group E（P%0.05）. Conclusion Ventilation with i-gel LMA in elderly patients undergoing urologic laparoscopy surgery is better than tracheal tube in keeping stable hemodynamics, producing less stress responses, having less complications and having rapid recovery.

关 键 词：i-gel喉罩 老年 泌尿外科 腔镜手术 

分 类 号：R614[医药卫生—麻醉学]