i-gel喉罩用于肥胖患者的气道管理  

Airway management of i-gel laryngeal mask in obese patients

作　　者：丁久红[1] 曹慧茹[1] 朱敏敏[1] 胡毅平[1] 

机构地区：[1]南京医科大学附属无锡第二医院麻醉科,214002

出　　处：《临床麻醉学杂志》2014年第2期150-153,共4页Journal of Clinical Anesthesiology

摘　　要：目的评估i-gel喉罩用于肥胖患者气道管理的安全性。方法择期全麻手术患者60例,BMI>30kg/m2,年龄18～65岁。随机均分为i-gel喉罩组(I组)和气管插管组(E组)。记录插入气管导管或喉罩所需时间、插入次数、成功率、拔管时间、苏醒时间;测量喉罩气道密封压(OLP),纤维支气管镜检查喉罩对位情况;记录入室后、插管前、插管即刻、拔除前、拔管即刻的HR、SBP、DBP及术后不良反应发生情况。结果 I组插入时间明显短于E组(P<0.01),喉罩首次置入成功率明显高于E组(P<0.05);I组插管(喉罩)即刻、拔管(喉罩)即刻HR明显慢于E组,SBP、DBP明显低于E组(P<0.05)。I组拔管(喉罩)时间、苏醒时间短于E组(P<0.05)。OLP为(28.7±6.5)cm H2O,所有患者OLP均大于Ppeak,喉罩对位良好。I组呛咳、咽痛明显低于E组(P<0.01),两组均未发生反流。结论肥胖患者全麻手术中i-gel喉罩与气管插管通气效果相同,但插管期和拔管期应激反应更小,不良反应更少,且简便快捷。Objective To assess the safety of airway management in obese patients used i-gelTM laryngeal mask （LMA）. Methods Sixty obese patients （BMI〉 30 kg/m^2） aged 18-65 years scheduled for elective surgery under general anesthesia were randomly divided into i-gel LMA insertion group （group I） and endotracheal intubation （ETT） group （group E）. The time spent for intubation, number of intubation times, success rates, extubation time of LMA and ETT and consciousness recovery time were recorded. Oropharyngeal leak pressure （OLP） and fiber optic laryngoscopy view were observed. HR, SBP, DBP during the period of intubation and extubation and adverse events were measured.Results Compare the time spent for intubation, group I significantly shorter than group E （P〈0. 01）. Success rates of the first attempt in group I were significantly higher than those in group E（P〈0.05）. Compare the HR, SBP, DBP values at intubation and extubation timepoint,group I significant less than group E （P〈0. 05）. The time spent for LMA extubation and consciousness recovery time in group I was significantly shorter than group E （P 〈0. 05）. The value of OLP was （28. 7± 6.5） cm H20 and correct placement confirmed by fibrotic visualization in all patients in group I. Incidence of bucking during intubation and sore throat after extubation in group I significantly lower than in group E （P 〈 0.01 ）. Neither aspiration nor regurgitation was observed in both groups. Conclusion i-gelTM LMA has same ventilation effect as ETT, hemodynamicresponse and incidence of adverse events in i-gelTM LMA lower than in ETT. i- gelTM LMA provides safe and easy airway management for obese patients.

关 键 词：i-gel喉罩 肥胖 气道管理 

分 类 号：R614[医药卫生—麻醉学]