I-gel喉罩与可弯曲喉罩在中耳炎手术中应用效果的比较  

The comparative effect of I-gel and fexible laryngeal airway mask(FLAM) undergoing otitis media surgery

作　　者：张华明[1] 康芳[1] 殷国兵[1] 黄祥[1] 李娟[1] 

机构地区：[1]安徽医科大学附属省立医院麻醉科,安徽合肥230001

出　　处：《麻醉安全与质控》2017年第3期123-126,共4页Perioperative Safety and Quality Assurance

基　　金：安徽省国际科技合作计划资助项目(1503062021)

摘　　要：目的比较I-gel喉罩与可弯曲喉罩(FLMA)用于中耳炎手术中的气道管理效果。方法全麻下行中耳炎手术患者100例,ASAI或Ⅱ级,随机均分为I-gel喉罩组(I组)和可弯曲喉罩组(F组)。记录喉罩置入成功率、置入时间、手术时间、苏醒时间、拔除喉罩时间;分别记录头颈正中位和侧旋位后喉罩的密封压、气道峰压(Ppeak)、纤维支气管镜(FOB)检查气道暴露情况;记录喉罩置入即刻(T_0)、头侧旋位即刻(T_1)、手术开始即刻(T_2)、手术开始后30 min(T_3)、拔除喉罩即刻(T_4)的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_2);记录外科医生对使用喉罩的满意度;记录拔除喉罩后血迹残留、咽痛等并发症的发生情况。结果喉罩置入时间I组(6.3±2.3)s优于F组(11.3±2.1)s;2组患者的喉罩置入成功率、手术时间、苏醒时间、拔除喉罩时间及各时点的HR、MAP、SpO_2差异无统计学意义;2组患者颈正中位和侧旋位喉罩的喉罩密封压、Ppeak、FOB检查气道暴露分级情况、外科医生满意度差异均无统计学意义;与I组比较,F组患者拔除喉罩后血迹残留及咽痛的发生率高于I组。结论 I-gel喉罩与FLMA喉罩均能安全有效地应用于中耳炎手术中的气道管理。但I-gel喉罩更易置入、血迹残留及咽痛发生少。Objective To investigate the comparative effect of I-gel and FLAM during otitis media surgery. Methods One hundred patients of ASA I or II classification undergoing otitis media surgery with general anesthesia were randomly divided into two groups （ Group I with I-gel and Group F with FLAM, respectively）. The time and success rate of airway mask placement, surgery time, wake time, and extuhation time were recorded. Sealing pressure and peak airway pressure of the laryngeal mask airway （LMA） in patients with supine and lateral positioning were assessed respectively. Fiberoptic bronchoscopy was also used to check airway exposure. Heart rate （HR） , mean arterial pressure （MAP）, and pulse oxygen saturation （SpOz） were recorded in insertion （TO ）, lateral position （T~）, the beginning of surgery （ T2 ） , post-surgery 30 min （ T3 ） , and extubation （ T4 ）. The surgeon＇s satisfaction with the use of the LMA was also recorded. Related complications such as blood residue after pulling out the LMA and sore throat were analyzed. Results The time of placement in Group I was less than that of Group F. Incidence of the related complications in Group I, bleeding caused by insertion and sore throat, were less compared to Group F. There was no significant difference in other indicators between the two groups. Conclusion Both types of LMA can be used safely and effectively in tympanitis patients undergoing otitis media surgery with general anesthesia; I-gel is easier for insertion and caused fewer complications. Conclusion Both types of LMA can he used safely and effectively in tympanitis patients under- going otitis media surgery with general anesthesia, I-gel is easier for insertion and caused fewer complications.

关 键 词：喉面罩 中耳炎 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]