I-gel喉罩用于腔镜甲状腺手术全麻患者的临床观察  

Ventilation effect of I-gel laryngeal mask used in endoscopic thyroid surgery under general anesthesia

作　　者：李晓婷[1,2] 王胜斌[2] 张野[1] 

机构地区：[1]安徽医科大学第二附属医院麻醉科,合肥230022 [2]安徽医科大学附属安庆医院麻醉科

出　　处：《天津医药》2015年第2期209-213,共5页Tianjin Medical Journal

基　　金：安徽省科技厅年度重点项目(1301043030)

摘　　要：目的观察I-gel喉罩用于腔镜甲状腺手术全麻患者通气的效果。方法择期全麻下行腔镜甲状腺手术患者60例,随机分为3组（n=20）：气管插管组、Supreme喉罩组和I-gel喉罩组。记录置入成功率,置入时间,Su-preme喉罩组和I-gel喉罩组记录气道密封压,并行纤维支气管镜检查评分,以评价喉罩对位情况。于置入前（T0）和置入后1 min（T1）、3 min（T2）时,建立CO2操作空间前（T3）,建立CO2操作空间后30 min（T4）,标本切除后10 min（T5）,拔除前（T6）和拔除后1 min（T7）时记录平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（Sp O2）,于T1-T5记录呼气末二氧化碳分压p（CO2）和气道峰压（Ppeak）。记录拔除后恶心呕吐、咽喉疼痛等不良反应发生的情况。结果 3组置入成功情况差异无统计学意义,与气管插管组比较,I-gel喉罩组和Supreme喉罩组置入的时间缩短（P〈0.05）;气道密封压和纤维支气管镜检查评分Supreme喉罩组和I-gel喉罩组差异无统计学意义。与气管插管组比较,Supreme喉罩组和I-gel喉罩组T1、T6、T7时点MAP、HR降低（P〈0.05）,3组各时点SpO2、呼气末p（CO2）和Ppeak比较差异无统计学意义。与Supreme喉罩组和气管插管组比较,I-gel喉罩组咽喉疼痛的发生率降低（P〈0.05）。与Supreme喉罩组比较,I-gel喉罩组罩体带血的发生率降低（P〈0.05）。结论 I-gel喉罩和Supreme喉罩均可安全有效地应用于腔镜甲状腺手术患者的气道管理,且I-gel喉罩的损伤更小,舒适度更佳。Objective general anesthesia. Methods A total of 60 cases of endoscopic thyroid surgery under general anesthesia, were randomly di-vided into 3 groups（n= 20）： the group that patients used endotracheal intubation（Group Q）; the group that patients employedSupreme laryngeal mask（Group S）; the group that patients wore I-gel laryngeal mask（Group I）. Success rate of insertion, du-ration of insertion, endotracheal pressure of Group S and Group I worerecored, and fiberoptic bronchoscopy was performed inGroup S and I to evaluate the position of laryngeal mask. Mean arterial pressure（MAP）, heart rate（HR）, pulse oxygen satura-tion（SpO2） at time points of before insertion（T0）, 1 min after insertion（T1）, 3 min after insertion（T2）, before the establishmentof CO2 operating space（T3）, 30 min after the establishment of CO2 operating space（T4）, 10 min after the resection of speci-mens（T5）, 1 min before removal of laryngeal mask（T6） and 1 min after the removal of laryngeal mask（T7） were recorded andthe end-tidal carbon dioxide pressure [ p（CO2） ]and peak airway pressure（Ppeak） form T1 to T5.were also recorded. Occur-rence of nausea and vomiting, sore throat and other adverse reactions after removal of laryngeal mask were also noted. Results The successful rate of insertion was not significant different among all three groups. Compared with Group Q, inser-tion time was significantly shorter in Group I and S（P〈0.05）. Endotracheal pressure and fiberoptic bronchoscopy score arenot statistically different between Group S and I. Compared with Group Q, MAP and HR in T1, T6 and T7were significantlylower in Group S and I（P〈0.05）. SpO2,p（CO2） and Ppeak show no statistical difference between three groups. Compared with Group S and Q, the occurrence of sore throat, painful swallowing and bleeding which is indicated by the appearance ofblood in laryngeal were all significantly lower in Group I（P〈0.05）. Conclusion Both I-gel laryngeal mask and Supremelary

关 键 词：麻醉 全身 喉面罩 腔镜 甲状腺切除术 

分 类 号：R614.2[医药卫生—麻醉学] R653[医药卫生—外科学]