SLIPA喉罩和LMA Supreme喉罩通气在老年患者行腹腔镜胆囊切除术中的应用比较  

Comparison of SLIPA and LMA supreme laryngeal mask airway in elderly patients undergoing laparoscopic cholecystectomy

作　　者：王涵[1] 伍志超[1] 黄艳[1] 袁卫国[1] WANG Han;WU Zhi-chao;HUANG Yan;YUAN Wei-guo(Department of Anesthesiology,Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属第二临床医学院麻醉科,四川南充637000

出　　处：《川北医学院学报》2021年第1期51-55,共5页Journal of North Sichuan Medical College

基　　金：四川省南充市校合作科技项目(18SXHZ0084)。

摘　　要：目的:在全麻行腹腔镜胆囊切除术(LC)的老年患者中,比较SLIPA喉罩和LMA Supreme喉罩对其血流动力学、呼吸力学及术中、术后并发症的影响。方法:将120例在全身麻醉下接受择期腹腔镜胆囊切除术的老年患者随机分为SLIPA喉罩组(S组,n=60),及LMA Supreme喉罩组(L组,n=60)。观察两组喉罩置入时间和首次尝试置入成功率。在患者麻醉诱导前(T_(0))、喉罩插入成功即刻(T_(1))、喉罩插入后5 min(T_(2))、拔出喉罩即刻(T_(3))、拔出喉罩后5min(T_(4)),分别记录患者心率(HR)和平均动脉压(MAP);记录气腹建立前及建立后10 min、20 min、30 min时患者气道压力峰值(Ppeak)、气道平台压力(Pplat)、气道平均压力(Pmean)、分钟通气量(MV)和呼气末二氧化碳分压(PETCO_(2));并观察患者术中胃胀、气道漏气及术后反流误吸、喉痉挛、咽喉痛、喉罩带血等并发症的发生情况。结果:S组和L组喉罩平均置入时间分别为12.9 s和7.6 s,首次尝试成功率分别为86.6%和98.3%。与S组相比,L组在T1和T3时点的HR、MAP显著降低(P<0.05)。两组患者在气腹建立后10 min、20 min及30 min的Ppeak、Pplat、Pmean、MV、PETCO_(2)、并发症的发生率比较,差异无统计学意义(P>0.05)。但术后喉罩带血S组为21.6%,L组为3.3%。结论:SLIP和LMA Supreme喉罩均能安全用于行腹腔镜胆囊切除术的老年患者的通气,但LMA Supreme喉罩置入成功率高于SLIPA喉罩,且对气道的损伤更小。Objective:To compare the safety and efficacy of the streamlined liner of the pharynx airway(SLIPA)and LMA Supreme laryngeal mask airway on hemodynamics,respiratory mechanics,intraoperative and postoperative complications in elderly patients undergoing laparoscopic cholecystectomy(LC).Methods:A total of 120 elderly patients undergoing elective LC under general anesthesia were randomly divided into two groups:SLIPA group(group S,n=60)and LMA Supreme group(group L,n=60).The first attempt success rate for laryngeal mask insertion and the insertion time were recorded.Patients'heart rate(HR)and mean arterial pressure(MAP)were monitored and recorded before the induction of anesthesia(T_(0)),just when the laryngeal mask were successfully inserted(T_(1)),5 min after inserting laryngeal mask(T_(2)),just when the laryngeal mask were removed(T_(3)),and 5 min after removing the laryngeal mask(T_(4)).Patients'peak airway pressure(Ppeak),airway platform pressure(Pplat),mean airway pressure(Pmean),minute ventilation(MV)and partial pressure of end-tidal carbon dioxide(PETCO_(2))were also analyzed before pneumoperitoneum establishment and 10,20 and 30 min after pneumoperitoneum establishment.Besides,the incidence of complications such as gastric distension,air leakage,postoperative reflux aspiration,laryngospasm,sore throat,blood stain on laryngeal mask and others were evaluated.Results:In the group S and group L,the mean insertion time were 12.9 s and 7.6 s,and the first attempt success rates of laryngeal mask insertion were 86.6%and 98.3%,respectively.Compared with group S,the HR and MAP in group L were significantly reduced at T1 and T3(P<0.05).The Ppeak,Pplat,Pmean,MV,PETCO_(2)and the incidences of complications had no statistical differences between the two groups before pneumoperitoneum establishment and 10,20 and 30 min after pneumoperitoneum establishment(P>0.05).The blood stain rate on the surface of the device in group S and group L was 21.6%and 3.3%.Conclusion:Both SLIP and LMA Supreme laryngeal masks can be safely used

关 键 词：SLIPA喉罩 LMA Supreme喉罩 老年患者 腹腔镜胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]