小儿斜视矫正术应用喉罩全身麻醉的临床效果观察  

Clinical effect observation of general anesthesia with laryngeal mask in pediatric strabismus surgery

作　　者：周小丹 熊思敏 叶菊香[1] ZHOU Xiao-dan;XIONG Si-min;YE Ju-xiang(Department of Anesthesiology,Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210003,China)

机构地区：[1]南京医科大学附属眼科医院麻醉科,210003

出　　处：《中国实用医药》2024年第18期137-140,共4页China Practical Medicine

摘　　要：目的分析小儿斜视矫正术应用喉罩全身麻醉的临床效果。方法选取72例斜视患儿,按随机数字表法分为对照组及研究组,各36例。两组均采用相同方法、药物进行麻醉诱导及麻醉维持,对照组行气管插管全身麻醉,研究组行喉罩全身麻醉。比较两组不同时间[麻醉诱导前(T0)、麻醉诱导后(T1)、插入气管插管/喉罩即时(T2)、插入气管插管/喉罩后5 min(T3)、拔出气管插管/喉罩前5 min(T4)、拔出气管插管/喉罩后5 min(T5)]的血流动力学指标[心率(HR)、血氧饱和度(SpO_(2))、平均动脉压(MAP)]水平,不良反应发生情况。结果研究组T1~T5时的HR、MAP水平与同组T0时比较,差异无统计学意义(P>0.05);两组T0~T5时的SpO_(2)水平比较,差异无统计学意义(P>0.05);对照组T2、T4时的HR、MAP水平较同组T0时更高(P<0.05);研究组T2、T4时的HR[(108.35±12.54)、(111.21±11.65)次/min]、MAP[(82.21±6.15)、(80.35±5.87)mm Hg(1 mm Hg=0.133 kPa)]较对照组的[(122.45±14.74)、(126.64±12.05)次/min]、[(94.58±6.24)、(92.65±5.36)mm Hg]更低(P<0.05)。研究组不良反应发生率8.33%低于对照组的30.56%(P<0.05)。结论小儿斜视矫正术应用喉罩全身麻醉,可减少麻醉苏醒期不良反应,对血流动力学影响较小,安全性高。Objective To analyze the clinical effect of general anesthesia with laryngeal mask in pediatric strabismus surgery.Methods A total of 72 children with strabismus were selected and divided into a control group and a study group,each with 36 cases.Anesthesia induction and maintenance were performed by the same methods and drugs in both groups.The control group was given general anesthesia with tracheal intubation and the study group was given general anesthesia with laryngeal mask.Both groups were compared in terms of hemodynamic indicators[heart rate(HR),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP)]levels at different time points[before anesthesia induction(T0),after anesthesia induction(T1),immediately after insertion of tracheal intubation/laryngeal mask(T2),5 min after insertion of tracheal intubation/laryngeal mask(T3),5 min before tracheal intubation/laryngeal mask removal(T4),and 5 min after tracheal intubation/laryngeal mask removal],and occurrence of adverse reactions.Results The HR and MAP levels at T1-T5 in the study group were not statistically significant when compared with those at T0 in the same group(P>0.05).There was no significant difference in SpO_(2) levels between the two groups at T0-T5(P>0.05).The levels of HR and MAP at T2 and T4 in the control group were higher than those at T0(P<0.05).At T2 and T4,the study group had HR of(108.35±12.54)and(111.21±11.65)times/min,and MAP of(82.21±6.15)and(80.35±5.87)mm Hg(1 mm Hg=0.133 kPa),which were lower than those of the control group[(122.45±14.74),(126.64±12.05)times/min and(94.58±6.24),(92.65±5.36)mm Hg](P<0.05).The incidence of adverse reactions in the study group was 8.33%,which was lower than 30.56%in the control group(P<0.05).Conclusion The application of general anesthesia with laryngeal mask in pediatric strabismus surgery can reduce the adverse reactions during the recovery period of anesthesia,and has little influence on hemodynamics and high safety.

关 键 词：小儿斜视 喉罩 气管插管 全身麻醉 麻醉复苏期 斜视矫正术 声音嘶哑 全身麻醉 

分 类 号：R726.1[医药卫生—儿科]