非清醒特殊放气囊法在小儿拔除喉罩中的应用  

Application of Non Conscious Special Bleeder Method in Laryngeal Mask Removal in Children

作　　者：许珊凤 XU Shanfeng(Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属中山医院,福建厦门361000

出　　处：《中国医药指南》2022年第28期69-71,75,共4页Guide of China Medicine

摘　　要：目的 探究非清醒气囊充气状态下拔除喉罩(LMA)和清醒气囊放气状态下拔除LMA对小儿麻醉复苏室(PACU)指标、血流动力学、术后舒适度及家属焦虑情况的影响。方法 该研究选取本院2020年7月至2021年12月PACU接收的200例全身麻醉小儿为研究对象,按随机数字表法将小儿分为试验组和对照组(n=100)。试验组在非清醒气囊充气状态下拔除LMA,对照组在清醒气囊放气状态下拔除LMA。观察两组PACU指标及不良事件发生情况,比较拔管前后血流动力学[血氧饱和度(SPO2)、心率(HR)]、术后小儿舒适度(FLACC评分)及家属焦虑情况(SAS评分)。结果 试验组喉罩拔管时间短于对照组(P <0.05),而PACU停留时间两组比较差异无显著性(P> 0.05)。;拔管后试验组SPO2高于对照组,HR低于对照组(P <0.05);术后试验组FLACC、SAS评分低于对照组(P <0.05);试验组喉痉挛、咽痛、躁动、严重呛咳等不良事件发生率均低于对照组(P <0.05)。结论 非清醒气囊充气状态下拔除LMA能缩短喉罩拔管时间,提高小儿舒适度,缓解家属焦虑,且能改善血流动力学,减少不良事件的发生。Objective To explore the effects of laryngeal mask(LMA) removal under non conscious air bag inflation and conscious air bag deflation on pediatric anesthesia and resuscitation unit(PACU) indicators, hemodynamics, postoperative comfort and family anxiety. Methods 200 children under general anesthesia received by PACU in our hospital from July 2020 to December 2021 were selected as the research objects. The children were randomly divided into experimental group and control group(n=100). The LMA was removed in the experimental group when the non conscious airbag was inflated, and in the control group when the conscious airbag was deflated. PACU indexes and adverse events were observed in the two groups, and hemodynamics(SpO2, HR), postoperative comfort of children(FLACC score) and family anxiety(SAS score) were compared before and after extubation. Results The extubation time of LMA in the experimental group was shorter than that in the control group(P<0.05), the difference in residence time between the two groups of PACU was not significant(P>0.05). After extubation, SpO2 in the experimental group was higher than that in the control group, and HR was lower than that in the control group(P<0.05). The scores of FLACC and SAS in the experimental group were lower than those in the control group(P<0.05). The incidence of adverse events such as laryngospasm, sore throat, restlessness and severe cough in the experimental group was lower than that in the control group(P<0.05). Conclusion LMA removal under non conscious air bag inflation can shorten the time of laryngeal mask extubation, improve the comfort of children, alleviate the anxiety of family members, improve hemodynamics and reduce the occurrence of adverse events.

关 键 词：全身麻醉 非清醒 小儿 气囊充气 喉罩 拔管 血氧饱和度 

分 类 号：R614[医药卫生—麻醉学]