侧卧位复苏在小儿喉罩全身麻醉苏醒期中的应用效果  

Application effect of resuscitation in lateral position on children during recovery period of laryngeal mask general anesthesia

作　　者：韦启清 覃春艳 韦珊珊[1] 韦柳萍 WEI Qi-qing;QIN Chun-yan;WEI Shan-shan;WEI Liu-ping(Department of Anesthesiology,Hechi Third People′s Hospital,Hechi 547000,China)

机构地区：[1]广西河池市第三人民医院麻醉科,河池市547000

出　　处：《广西医学》2021年第17期2058-2061,共4页Guangxi Medical Journal

基　　金：广西河池市科学研究与技术开发计划(河科B1824-43)。

摘　　要：目的观察侧卧位复苏在喉罩全身麻醉苏醒期患儿中的应用效果及安全性。方法将60例行喉罩全身麻醉的患儿随机分为A组与B组,每组30例。手术结束后,A组患儿采用常规平卧位进行麻醉复苏,B组患儿采用侧卧位进行麻醉复苏。观察患儿拔除喉罩时间、麻醉恢复室停留时间。记录两组患儿入麻醉恢复室时(T_(0))、喉罩拔除前(T_(1))、喉罩拔除后1 min(T_(2))、喉罩拔除后5 min(T_(3))、喉罩拔除后10 min(T_(4))、喉罩拔除后20 min(T_(5))、喉罩拔除后30 min(T_(6))的心率、脉搏血氧饱和度(SpO_(2))值;比较两组患儿低氧血症、喉罩移位情况、需要吸痰、躁动或呛咳等不良反应发生情况。结果A组患儿拔除喉罩时间和麻醉恢复室停留时间均长于B组(均P<0.05);两组患儿不同时点的心率及SpO_(2)比较,差异均无统计学意义(均P>0.05);A组患儿拔除喉罩后低氧血症发生率、躁动发生率、需要吸痰比例均高于B组(均P<0.05),而两组苏醒期喉罩移位发生率差异无统计学意义(P>0.05)。结论相较于传统的平卧位,侧卧位复苏更利于喉罩全麻苏醒期患儿的呼吸道管理,提高复苏质量,安全性更高。Objective To observe the application effect and safety of resuscitation in the lateral position in children during recovery period of laryngeal mask general anesthesia.Methods Sixty children undergoing laryngeal mask general anesthesia were randomly divided into group A and group B,with 30 cases in each group.After the end of operation,children in group A were resuscitated in the conventional supine position,and children in group B were resuscitated in the lateral position.An observation was performed in the children on laryngeal mask removal time and postanesthesia care unit stay.The heart rate and pulse oxygen saturation(SpO_(2))values of children in the two groups were recorded when they entered the postanesthesia care unit(T_(0)),before laryngeal mask removal(T_(1)),one minute(T_(2)),five minutes(T_(3)),10 minutes(T_(4)),20 minutes(T_(5))and 30 minutes(T_(6))after laryngeal mask removal;the incidence of hypoxemia,displacement of laryngeal mask,number of cases needing sputum suction,agitation or coughing,and other adverse reactions were compared between the two groups.Results Group A exhibited prolonged laryngeal mask removal time and postanesthesia care unit stay(all P<0.05),there was no statistically significant difference in heart rate or SpO_(2)between the two groups at different time points(all P>0.05);group A yielded higher incidence rates of hypoxemia and agitation and a higher proportion of cases needing sputum suction after laryngeal mask removal as compared with group B(all P<0.05),whereas there was no statistically significant difference in incidence rate of laryngeal mask displacement during recovery period between the two groups(P>0.05).Conclusion Compared with traditional supine position,resuscitation in the lateral position is more conducive to respiratory tract management in children during recovery period of laryngeal mask general anesthesia,improving quality of resuscitation and achieving relatively high safety.

关 键 词：全身麻醉 苏醒期 侧卧位 小儿 喉罩 复苏质量 安全性 

分 类 号：R614.2[医药卫生—麻醉学]