喉罩通气联合右美托咪定麻醉在小儿腹腔镜疝气手术中的应用  

Application of laryngeal mask airway ventilation combined with dexmedetomidine anesthesia in laparoscopic hernia surgery in children

作　　者：周树强[1] 刘伟武[2] 徐国勇 吴剑 周积武 周雪锋[1] 黎冬梅 ZHOU Shuqiang;LIU Weiwu;XU Guoyong;WU Jian;ZHOU Jiwu;ZHOU Xuefeng;LI Dongmei(Department of Anesthesiology,Yulin Maternal and Child Health Hospital,Yulin 537000,Guangxi,China;Department of Obstetrics and Gynecology,Yulin Maternal and Child Health Hospital,Yulin 537000,Guangxi,China;Department of Pediatric Surgery,Yulin Maternal and Child Health Hospital,Yulin 537000,Guangxi,China)

机构地区：[1]广西玉林市妇幼保健院麻醉科,广西玉林537000 [2]广西玉林市妇幼保健院妇产科,广西玉林537000 [3]广西玉林市妇幼保健院小儿外科,广西玉林537000

出　　处：《右江医学》2023年第9期780-784,共5页Chinese Youjiang Medical Journal

基　　金：玉林市科学研究与技术开发计划项目(玉市科20212215)。

摘　　要：目的观察喉罩通气联合右美托咪定麻醉在小儿腹腔镜疝气手术中的应用效果。方法将玉林市妇幼保健院2021年7月至2022年7月收治的60例行腹腔镜疝气手术患儿作为研究对象,随机分为对照组和实验组,每组30例。对照组采用传统气管插管全麻,实验组采用喉罩通气联合右美托咪定麻醉。记录两组全麻诱导时间、术中通气情况、患儿苏醒时间,气管插管或插喉罩的患儿反应及生命征变化,麻醉情况(麻醉效果、术中麻醉质量、手术医生综合评级),不良反应(躁动、术后随访声音嘶哑及咽痛等情况)和患儿或家属满意度。结果实验组患儿全麻诱导时间及苏醒时间明显短于对照组,差异有统计学意义(P<0.05)。两组患儿术中通气情况相比,差异无统计学意义(P>0.05),两组患儿在T 1~T 4时间段的气管插管或插喉罩的血氧以及T 1的收缩压、舒张压、心率相比,差异无统计学意义(P>0.05)。而在T 2~T 4时间段实验组患儿收缩压、舒张压、心率较对照组更低更平稳,两组相比差异有统计学意义(P<0.05)。患儿的麻醉效果优率、术中麻醉质量优率及手术医生综合评级为Ⅰ级率,两组相比差异无统计学意义(P>0.05)。而实验组患儿发生躁动情况、术后随访声音嘶哑及咽痛率显著低于对照组,患儿或家属满意度高于对照组,两组比较差异有统计学意义(P<0.05)。结论在小儿腹腔镜疝气手术中,喉罩通气联合右美托咪定麻醉可明显缩短全麻诱导时间及患儿苏醒时间,手术过程生命征更平稳,躁动情况、术后随访声音嘶哑及咽痛发生率低,显著提升患儿及家属对于麻醉的满意程度,效果理想。Objective To observe the application of laryngeal mask airway ventilation combined with dexmedetomidine anesthesia in laparoscopic hernia surgery in children.Methods 60 children undergoing laparoscopic hernia surgery from July 2021 to July 2022 were randomly divided into control group and experimental group,with 30 cases in each group.The control group were given general anesthesia with traditional tracheal intubation,and the experimental group were given laryngeal mask airway ventilation combined with dexmedetomidine anesthesia.And then,the induction time of general anesthesia,ventilation during surgery,time of recovery of children in both groups,the changes of reactions and vital signs of children with endotracheal intubation or laryngeal mask insertion,anesthesia(anesthesia effects,the quality of anesthesia during surgery,and the comprehensive rating of surgeon),adverse reactions(restlessness,hoarseness and sore throat in follow-up after surgery,etc)and satisfaction of children or their families were recorded.Results The induction time of general anesthesia and the recovery time of children in the experimental group were significantly shorter than those in the control group,and difference was statistically significant between the two groups(P<0.05).There was no statistically significant difference between the two groups in terms of ventilation during surgery(P>0.05).There was no statistically significant difference of blood oxygen at T 1-T 4 as well as systolic blood pressure,diastolic blood pressure and heart rate at T 1 among children with endotracheal intubation and laryngeal mask insertion(P>0.05).The systolic blood pressure,diastolic blood pressure and heart rate of the children in the experimental group during T 2-T 4 period were lower and more stable than those in the control group,and difference was statistically significant(P<0.05).There was no statistically significant difference in the excellent rate of anesthesia effect,the excellent rate of anesthesia quality during surgery and the comprehensive r

关 键 词：喉罩通气 右美托咪定 联合麻醉 小儿腹腔镜 疝气手术 

分 类 号：R614.2[医药卫生—麻醉学] R656.2[医药卫生—外科学]