老年髋部手术应用不同无菌一次性喉罩全麻的比较及对术后镇痛的影响  

Comparative study on anesthesia and postoperative analgesia effects of sufentanil combined with propofol for general anesthesia with the three sterile and disposable laryngeal masks in the elderly undergoing hip surgery

作　　者：邢秀花 符先先[2] 倪文宗[1,3] 于姗姗 Xing Xiuhua;Fu Xianxian;Ni Wenzong;Yu Shanshan(Department of Anesthesiology,Haikou Orthopaedics Diabetes Hospital,Shanghai No.6 People′s Hospital,Haikou 570311,China)

机构地区：[1]上海市第六人民医院海口市骨科与糖尿病医院麻醉科,海口570311 [2]中南大学湘雅医学院附属海口医院检验科 [3]上海交通大学附属上海市第六人民医院麻醉科

出　　处：《中国临床保健杂志》2023年第2期206-209,共4页Chinese Journal of Clinical Healthcare

基　　金：海南省卫生健康行业科研项目(20A200096)。

摘　　要：目的 比较3种无菌一次性喉罩用于舒芬太尼复合丙泊酚全身麻醉对老年髋部手术麻醉及术后镇痛效果的影响。方法 以2019年12月至2021年12月150例老年髋部手术患者为研究对象,采用随机数字表法将其分为驼人组、SLIPA组、可视组,分别给予驼人喉罩、SLIPA喉罩、可视喉罩用于舒芬太尼复合丙泊酚全身麻醉,每组50例。比较3组麻醉效果及喉罩置入情况、呼吸功能指标,采用视觉模拟评分法(VAS)评定患者术后各时间段的疼痛程度,并统计患者拔除喉罩时不良反应发生情况。结果 3组麻醉起效时间、苏醒时间、拔管时间及麻醉阻滞持续时间对比无明显差异(P>0.05);驼人组的下床活动时间短于SLIPA组、可视组(P<0.05),可视组喉罩置入成功所需时间长于驼人组、SLIPA组,喉罩首次置入成功率高于驼人组、SLIPA组(P<0.05);3组术前、放置喉罩后1 min(T_(1))、5 min(T_(2))、10 min(T_(3))、拔除喉罩时(T_(4))及术毕即刻的呼气末二氧化碳(EtCO_(2))、气道峰压(Peak)、血氧饱和度(SpO_(2))及术后VAS评分对比,差异无统计学意义(P>0.05);驼人组的不良反应发生率低于SLIPA组、可视组(P<0.05)。结论 3种无菌一次性喉罩用于舒芬太尼复合丙泊酚全身麻醉对老年髋部手术麻醉及术后镇痛效果相当,其中驼人牌喉罩可降低拔除喉罩时呛咳发生率,可视性喉罩可提高喉罩置入成功率。Objective To compare the anesthesia and postoperative analgesia effects of sufentanil combined with propofol for general anesthesia with the three sterile and disposable laryngeal masks in the elderly undergoing hip surgery.Methods A total of 150 elderly patients undergoing hip surgery were enrolled as the research objects between December 2019 and December 2021.According to random number table method,they were divided into Tuoren group,SLIPA group and visual group,50 cases/group.The above groups were given sufentanil combined with propofol for general anesthesia with Tuoren,SLIPA and visual laryngeal masks,respectively.The anesthesia effect,placement of laryngeal masks and respiratory function indexes were compared among the three groups.The postoperative pain was evaluated by visual analogue scale(VAS).The occurrence of adverse reactions after removal of laryngeal masks was statistically analyzed.Results There was no significant difference in onset time of anesthesia,recovery time,extubation time or duration of anesthesia block among the three groups(P>0.05).The leaving bed time in Tuoren group was shorter than that in SLIPA group and visual group(P<0.05).The spending time of successful laryngeal mask placement in visual group was longer than that in Tuoren group and SLIPA group,and success rate of the first placement was higher than that in Tuoren group and SLIPA group(P<0.05).The difference in end-tidal carbon dioxide(EtCO_(2)),peak airway pressure(Peak)and oxygen saturation(SpO_(2))at before surgery,1 min(T_(1)),5 min(T_(2))and 10 min(T_(3))after laryngeal mask placement and removal time of laryngeal mask(T_(4))and immediately after surgery and postoperative VAS score among the three groups was not statistically significant(P>0.05).The incidence of adverse reactions in Tuoren group was lower than that in SLIPA group and visual group(P<0.05).Conclusions The anesthesia and postoperative analgesia effects of sufentanil combined with propofol for general anesthesia with the three sterile and disposable laryngeal

关 键 词：髋骨折 麻醉 吸入 疼痛 手术后 药物相关性副作用和不良反应 老年人 

分 类 号：R614[医药卫生—麻醉学]