不同充气容积对小儿经典喉罩密闭性与套囊内压力的影响  

The effect of different inflation volumes on the tightness and cuff pressure of classic laryngeal mask airway in children

作　　者：马韵 李芳 谭玲[1] 陈本祯[2] MA Yun;LI Fang;TAN Ling;CHEN Ben-zhen(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Anesthesiology,Sichuan Provincial Women’s and Children’s Hospital,Chengdu 610045,China)

机构地区：[1]四川大学华西医院麻醉科,四川成都610041 [2]四川省妇幼保健院四川省妇女儿童医院麻醉科,四川成都610045

出　　处：《实用医院临床杂志》2024年第4期67-70,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫生健康委员会重点科研项目(编号:19 ZD009)。

摘　　要：目的 观察小儿喉罩全麻下不同充气容积对喉罩密闭性与套囊内压力的影响。方法 选择120例拟行喉罩全麻下手术的患儿,根据患儿体重分为A、B、C、D组,其中A组15例,B组36例,C组38例,D组31例,分别采用1号、1.5号、2号、2.5号喉罩,套囊充气至喉罩有轻微移位,记录初始压力及初始充气容积,调整套囊内压力至60 cmH_(2)O,记录此时的充气容积。同时记录喉罩的漏气量(M1),如果套囊内压力>60 cmH_(2)O,调整套囊内压力至60 cmH_(2)O,记录此刻的漏气量(M2),若喉罩在套囊内压力为60 cmH_(2)O时仍具有较好的密闭性,则尝试将喉罩套囊内压力调整到50 cmH_(2)O,记录此刻的漏气量(M3)。结果 1号、1.5号、2号及2.5号喉罩初始容积分别为(3.80±0.41)、(5.63±0.65)、(8.33±0.94)、(11.93±1.58)ml,套囊内压力保持在60cmH_(2)O所需要的充气容积分别为(2.75±0.26)、(4.95±0.54)、(6.93±0.63)和(10.21±1.45) ml,所有型号喉罩的初始充气容积与最终充气容积比较,差异均有统计学意义(P<0.05)。四组间在不同套囊内压力下对应的漏气量比较,差异均有统计学意义(P<0.05)。结论 小儿喉罩全麻时全凭经验进行套囊内充气后,套囊内压力远远高于临床最大推荐套囊内压力值,咽喉部漏气量也最多。在小儿喉罩全麻时应常规监测套囊内压力,以免过度充气。Objective To observe the effect of different inflation volume on the tightness and cuff pressure of laryngeal mask airway(LMA)under general anesthesia in children.Methods A total of 120 children scheduled for surgery under general anesthesia with laryngeal mask airway(LMA)were selected.The children were divided into groups A,B,C and D according to their weight,including 15 cases in group A,36 cases in group B,38 cases in group C and 31 cases in group D.The corresponding laryngeal mask(No.1,No.1.5,No.2 and No.2.5)was inserted.The cuff was slowly inflated until the LMA was slightly displaced.The cuff was connected to pressure sensor to measure pressure.The initial pressure and initial inflation volume were recorded.The pressure inside the cuff was adjusted to 60 cmH_(2)O and the inflation volume that was required to maintain this pressure was recoded.At the same time,the leakage volume(M1)of the LAM was recorded.If the pressure inside the cuff was greater than 60cmH_(2)O,the pressure inside the cuff was adjusted to 60cmH_(2)O,and the air leakage(M2)of the LMA at the moment was recorded.If the LMA stll was good airtight when the pressure inside the cuff was 60cmH_(2)O,the pressure inside the cuff was tried to adjust to 50 cmH_(2)O.The air leakage(M3)of the LMA was recorded at the moment.Results The initial volume of the LMA with sizes 1,1.5,2 and 2.5 was(3.80±0.41),(5.63±0.65),(8.33±0.94),and(11.93±1.58)ml,respectively.The insufflation volumes required to maintain the cuff pressure at 60cmH_(2)O were(2.75±0.26),(4.95±0.54),(6.93±0.63)and(10.21±1.45)ml,respectively.The differences were statistically significant(P<0.05).There were statistically significant differences in the air leakage volumes between the four groups among the LMA with sizes 1,1.5,2 and 2.5 under different cuff pressures(P<0.05).Conclusions The inflation volume required to maintain appropriate cuff pressure during general anesthesia of LMA in children is much lower than the maximum inflation volume recommended by the manufacturer.After inflat

关 键 词：经典喉罩 套囊充气容积 小儿 压力 

分 类 号：R614.2[医药卫生—麻醉学]