喉罩通气全麻对输尿管中下段结石患者术中血压、心率变化及术后疼痛程度的影响  

Effect of general anesthesia with laryngeal mask ventilation on intraoperative blood pressure,heart rate changes and postoperative pain level in patients with middle and lower ureteral calculi

作　　者：张荣[1] 陈丽青[1] 黎天才 ZHANG Rong;CHEN Li-qing;LI Tian-cai(Department of Anesthesiology,Yingde People′s Hospital,Guangdong Province,Yingde513000,China)

机构地区：[1]广东省英德市人民医院麻醉科,广东英德513000

出　　处：《中国当代医药》2021年第23期180-183,共4页China Modern Medicine

摘　　要：目的分析喉罩通气全麻在输尿管中下段结石患者手术中的效果。方法选取2019年6月—2020年7月广东省英德市人民医院接收的68例输尿管中下段结石患者,均行经尿道输尿管镜钬激光碎石术,结合电脑随机数字表法以1∶1比例分为两组,局麻组(34例)接受腰硬联合麻醉,喉罩组(34例)接受喉罩通气全麻。比较两组的麻醉效果,不良反应,术后6、12、24 h疼痛度[疼痛数字评分法(NRS)]及麻醉前、麻醉10 min、手术10 min时血流动力学指标[平均动脉压(MAP)、心率(HR)]。结果喉罩组的麻醉效果优于局麻组,差异有统计学意义(P<0.05)。术后12、24 h喉罩组的NRS评分低于局麻组,差异有统计学意义(P<0.05)。麻醉10 min、手术10 min喉罩组的MAP、HR高于局麻组,差异有统计学意义(P<0.05)。喉罩组的不良反应总发生率为5.88%(2/34),低于局麻组的26.47%(9/34),差异有统计学意义(P<0.05)。结论输尿管中下段结石患者术中应用喉罩通气全麻,可提高麻醉效果,减轻术后疼痛度,维持血流动力学稳定,并减少不良反应发生。Objective To analyze the effect of general anesthesia with laryngeal mask ventilation in patients with middle and lower ureteral calculi during surgery.Methods From June 2019 to July 2020,68 patients with middle and lower ureteral calculi admitted to Yingde People′s Hospital of Guangdong Province were selected,all of whom underwent transurethral ureteroscopic holmium laser lithotripsy.They were divided into two groups in 1∶1 ratio by combining the computerized random number table method.The local anesthesia group(34 cases)received combined spinal-epidural anesthesia and the laryngeal mask group(34 cases)received general anesthesia with laryngeal mask ventilation.The two groups were compared in terms of anesthetic effect,adverse effects,pain degree([numerical rating scale]NRS)at 6,12 and 24 h after surgery,and hemodynamics indicators(mean arterial pressure[MAP]and heart rate[HR])before anesthesia,10 min of anesthesia and 10 min of surgery.Results The anesthetic effect of the laryngeal mask group was better than that of the local anesthesia group,and the difference was statistically significant(P<0.05).The NRS scores of the laryngeal mask group were lower than those of the local anesthesia group at 12 h and 24 h after surgery,with statistically significant differences(P<0.05).The MAP and HR in the laryngeal mask group were higher than those in the local anesthesia group at 10 min of anesthesia and 10 min of surgery,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the laryngeal mask group was 5.88%(2/34),lower than that in the local anesthesia group accounting for 26.47%(9/34),and the difference was statistically significant(P<0.05).Conclusion General anesthesia with laryngeal mask ventilation can improve the anesthetic effect,reduce the degree of postoperative pain,maintain hemodynamic stability,and reduce the occurrence of adverse reactions when used in patients with middle and lower ureteral calculi.

关 键 词：喉罩通气全麻 腰硬联合麻醉 输尿管中下段结石 经尿道输尿管镜钬激光碎石术 

分 类 号：R614[医药卫生—麻醉学]