全身麻醉操作者处不同位置对喉罩置入时间及成功率的影响  

The effect of different positions of operators on the time and success rate of laryngeal mask implantation under general anesthesia

作　　者：段明达 冯龙[1] 袁维秀[1] 傅强[2] 曹江北[2] DUAN Mingda;FENG Long;YUAN Weixiu;FU Qiang;CAO Jiangbei(Department of Anesthesiology,Hainan Hospital of General Hospital of People's Liberation Army,Sanya Hainan 572013,China;不详)

机构地区：[1]解放军总医院海南医院麻醉科,海南三亚572013 [2]解放军总医院第一医学中心麻醉科,北京100853

出　　处：《中国急救复苏与灾害医学杂志》2022年第6期798-801,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家重点研发计划(编号:2020YFC0811003);解放军总医院临床科研扶持基金-军事医学创新专项(编号:2018FC-WJFWZX-2-10)。

摘　　要：目的比较操作者处于患者头侧或对侧,对置入i-gel或SLIPA喉罩时间及一次成功率的影响,为院外急救选择合适的气道工具提供依据。方法选择全身麻醉患者300例,随机分为4组:i-gel(I组)头侧组(操作者位于患者头侧)和对侧组(操作者位于患者头对侧),SLIPA(S组)头侧组和对侧组,每组75例。分别由5名无经验规培生使用2种不同喉罩在2个不同操作位置各操作15例。比较两组喉罩置入时间,一次置入成功率及术后并发症等情况。结果操作者从头侧置入喉罩时,I组与S组一次置入成功率分别为82.4%,82.2%,差异无统计学意义(P>0.05);操作者从患者对侧置入喉罩时,I组一次置入成功率高于S组(77.3%vs 60.8%,P=0.03)。无论操作者位于头侧还是对侧,I组喉罩置入时间均小于S组,差异有统计学意义(P<0.05);与对侧相比,S组在头侧一次置入成功率更高(82.2%vs 60.8%,P=0.002),而I组差异无统计学意义(P>0.05)。结论无论操作者在患者头侧或对侧,均能利用SLIPA或i-gel喉罩建立人工气道。与置入SLIPA喉罩相比,i-gel喉罩置入时间及一次成功率受操作者位置的影响更小。Objective To compare the effects of different positions of operator on the time and one-time success rate of i-gel or SLIPA laryngeal mask placement,so as to provide basis for selecting appropriate airway tools for out of hospital first aid.Methods 300 patients under general anesthesia were randomly divided into 4 groups:i-gel(group I)cranial group and caudal group,SLIPA(Group S)cranial group and caudal group,with 75 cases in each group.Five resident anesthsiologists used two different kinds of laryngeal masks to operate 15 cases in two different operation positions.The time of laryngeal mask implantation,the success rate of one-time implantation and postoperative complications were compared.Results When the anesthesiologist was on the cranial side,the success rates of group I and group S were 82.4%and 82.2%respectively,and there was no significant difference between the two groups(P>0.05).On the caudal side,however,the success rate of one-time placement in group I was higher than that in group S(77.3%vs 60.8%,P=0.03).The insertion time in group I was shorter than that in group S whether the operator was in cranial side or caudal side.Compared with in the caudal side,the success rate in group S was higher when the operator was on the cranial side(82.2%vs 60.8%,P<0.002),but there was no significant difference in group I in both positions.Conclusion The establishment of artificial airway can be completed by using i-gel or SLIPA laryngeal mask whether on the cranial or caudal side of patients.The success rate of the first insertion and time of establishment seems to less impacted by the position of the operator when using the i-gel laryngeal mask than using the SLIPA laryngeal mask.

关 键 词：麻醉操作者位置 喉罩 置入时间 一次成功率 术后并发症 

分 类 号：R614[医药卫生—麻醉学]