超声引导置入喉罩麻醉对老年人围术期通气质量的影响  

Effect of ultrasound-guided laryngeal mask anesthesia on the quality of perioperative ventilation in elderly patients

作　　者：钟挺[1] 黄丽萍[1] 冯政 谢颖 Zhong Ting;Huang Liping;Feng Zheng;Xie Ying(Department of Anesthesia,the 903 Hospital,Jiangyou 621700,China;不详)

机构地区：[1]九〇三医院麻醉科,江油621700 [2]四川省南充市中心医院麻醉科

出　　处：《中国临床保健杂志》2021年第6期810-813,共4页Chinese Journal of Clinical Healthcare

基　　金：四川省医学会科研项目(S17041)。

摘　　要：目的探讨超声引导喉罩全身麻醉的安全性和可行性,以及对老年人围术期通气质量的影响。方法选择2019年1月至2020年1月在九〇三医院择期行外科手术的124例老年患者,年龄(66.5±5.8)岁,采用随机数字法分为对照组和观察组各62例。对照组采用常规喉罩置入法进行静脉全身麻醉,观察组采用超声引导喉罩置入法。采用纤维支气管镜判断喉罩定位的优良率,置入前、置入后10 min、置入后60 min、手术结束前10 min、拔除后30 min的平均心率(HR)、呼吸频率、平均动脉压(MAP)、动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))和动脉血二氧化碳分压(PaCO_(2)),喉罩拔除不良反应、拔除后30 min吞咽咽喉痛视觉模拟量表(VAS)评分。结果观察组喉罩定位的优良率显著高于对照组(P<0.05)。与对照组相比,观察组在喉罩置入后10 min、置入后60 min、术前10 min、拔除后30 min的HR、呼吸频率、MAP、SaO_(2)、PaO_(2)和PaCO_(2)波动幅度降低(P<0.05)。观察组喉罩拔除不良反应发生率降低,咽喉痛VAS评分减小(P<0.05)。结论超声引导置入喉罩全身麻醉有较好的安全性和可行性,提高了喉罩精准定位,改善了老年人围术期通气质量,喉罩拔除不良反应更少,咽喉痛更轻。Objective To explore the safety and feasibility of ultrasound-guided laryngeal mask implantation during general anesthesia and its effect on perioperative ventilation quality in elderly patients.Methods A total of 124 elderly patients with average age of(66.5±5.8)years were enrolled for selected surgery in our hospital during January 2019 to January 2020.They were randomly divided into control group and observation group with 62 cases in each group.The control group was given intravenous general anesthesia with routine laryngeal mask implantation,and the observation group was given laryngeal mask implantation guided by ultrasound.The excellent rate of laryngeal mask location was judged by fiberbronchoscopy.The hemodynamic change before implantation,10 minutes after implantation,60 minutes after implantation,10 minutes before the end of operation and 30 minutes after extubation including mean heart rate(HR),respiratory rate,mean arterial pressure(MAP),arterial oxygen saturation(SaO_(2)),arterial oxygen and partial pressure of carbon dioxide(PaO_(2) and PaCO_(2))were recorded.In addition,it was necessary to collect adverse reactions of extubation and VAS score of laryngopharyngeal pain when swallowing 30 minutes later.Results The excellent rate of laryngeal mask location in observation group was significantly higher than that of control group(P<0.05).Compared with the control group,the hemodynamic indicators including HR,respiratory rate,MAP,SaO_(2),PaO_(2) and PaCO_(2)10 minutes after implantation,60 minutes after implantation,10 minutes before the end of operation and 30 minutes after extubation in the observation group had less fluctuation range(P<0.05).In addition,the incidence of adverse reactions and VAS score of pharyngeal pain after extubation in observation group were less than control group(P<0.05).Conclusions Ultrasound-guided laryngeal mask general anesthesia has better safety and feasibility,which can improves the accurate position of laryngeal mask and the quality of perioperative ventilation in elde

关 键 词：麻醉 全身 围手术期医护 喉面罩 超声检查 呼吸生理学现象 

分 类 号：R47[医药卫生—护理学]