全麻诱导前加温SLIPA喉罩对术后咽喉部并发症的影响  

The effects of thermal softening of streamlined liner of pharyngeal airway before anesthesia induction on postoperative throat complications

作　　者：耿桂启[1] 陈颖洁[1] 刘海恋[1] 刘艳[1] 

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海200090

出　　处：《复旦学报（医学版）》2016年第5期591-594,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨预先加热流线形尾管的咽部气道(streamlined liner of pharyngeal airway,SLIPA)喉罩的安全性以及对术后并发症的影响。方法将10只SLIPA喉罩连同纸塑包装一起预先放至42℃暖箱中,24 h后取出打开包装以无菌棉签擦拭表面进行细菌培养,室温放置的10只SLIPA喉罩同样进行细菌培养。选择全麻下妇科宫腔镜手术患者100例,随机分为加温组和对照组(各50例);加温组在全麻诱导前先将SLIPA喉罩预先放入42℃暖箱中1 h,诱导后将加温的SLIPA喉罩涂抹石蜡油后进行置入;对照组则在全麻诱导后将室温SLIPA喉罩涂抹石蜡油进行置入;所有喉罩置入均由同一操作者进行。记录喉罩置入时间、最大气道密封压、置入前后血流动力学变化、喉罩拔除后血迹阳性率、咽喉痛及视觉模拟评分情况。结果两组SLIPA喉罩细菌培养结果均为阴性。加温组和对照组喉罩置入时间分别为(7.1±2.5)s和(8.8±3.8)s,差异有统计学意义(P=0.02);两组最大气道密封压分别为25.1 cmH2O和23.5 cmH2O,差异无统计学意义;喉罩置入后平均动脉压以及心率较置入前均明显升高,但组间比较差异无统计学意义;加温组喉罩拔除后血迹阳性率、咽喉痛发生率以及咽喉痛评分(12%、56%、1.4±1.1)显著低于对照组(40%、100%、3.1±2.4)(P<0.05)。结论 SLIPA喉罩预先加温有利于置入,并可以降低置入后相关并发症。Objective To verify the safty of streamlined liner of pharyngeal airway（SLIPA）and whether preheating it could decrease the associated complication of placement. Methods Bacterial culture was conducted for SLIPA at room temperature and SLIPA heated at 42 ℃ for 24 hours.One hundred patients scheduled for hysteroscopic surgery to whom SLIPA was considered suitable were randomly allocated to preheating group or control group（50 cases for each group）.The SLIPA in preheating group was placed in incubator which was set at 42 ℃ 1 hour before using and that in the control group was placed in room temperature of 24 ℃.The procedure was manipulated by the same operator.The duration of insertion,mean maximum sealing pressure and hemodynamics change as well as bloodstain incidence were evaluated and compared between the two groups.Patients were interviewed at recovery room about sore throat and visual analoge scale（VAS）score. ResultsBacterial culture was negative in SLIPA at room temperature and SLIPA heated at 42℃for 24 hours.The duration of insertion was（7.1±2.5）s in preheating group and（8.8±3.8）s in control group with significant statistical difference（P=0.02）.There was no statistical difference in the maximum sealing pressure between the two groups（25.1 cmH2 Ovs.23.5 cmH2O）.Mean arterial pressure and heart rate were all elevated after SLIPA was inserted either in preheating group or in the control group,but no significant difference was found between the two groups.There were statistical differences in incidence of blood stains,sore throat and VAS score of sore throat between preheating group（12%,56%,1.4±1.1）and control group（40%,100%,3.1±2.4）（P 〈0.05）. ConclusionsPreheating of the SLIPA decreased the complications related with the insertion of SLIPA.

关 键 词：加温处理 SLIPA喉罩 咽喉痛 

分 类 号：R614.2[医药卫生—麻醉学]