I-gel喉罩用于新生儿腹腔镜手术全身麻醉的气道管理

发布时间：2018-02-25 18:33

本文关键词： I-gel喉罩新生儿腹腔镜手术　出处：《实用医学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的评价I-gel喉罩用于新生儿腹腔镜手术全身麻醉的气道管理效果。方法选择行腹腔镜手术的新生儿40例,随机均分为I-gel喉罩组(I组)和气管插管组(E组),各20例。麻醉诱导后,I组患儿置入1号I-gel喉罩,E组患儿插入ID 3.0(或3.5 mm)无套囊气管导管通气,分别记录置入时间和置入成功率,以及置入后不同时间点的血流动力学指标,包括平均动脉压(MAP)、心率(HR)和脉搏血氧饱和度(Sp O2);记录置入后的呼气末二氧化碳分压(PETCO2)、气道峰压(Ppeak)和气道密封压;同时记录术后不良反应的发生情况。结果两组患儿插管(喉罩)成功率差异无显著性(P0.05);但I组患儿喉罩置入时间显著低于E组患儿的气管插管所需时间(P0.01)。T1时I组患儿MAP、HR较E组明显降低(P0.05);T1~T3时,与E组比较,I组Pleak显著降低(P0.01)。且I组患儿拔喉罩后不良反应发生率明显少于E组(P0.05),两组患儿均无反流误吸发生。结论 I-gel喉罩用于新生儿腹腔镜手术全身麻醉的气道管理可取得与气管插管相同的通气效果,且操作便捷,成功率高,并发症少。
[Abstract]:Objective to evaluate the effect of I-gel larynx mask on airway management of neonates undergoing laparoscopic general anesthesia. Methods 40 neonates undergoing laparoscopic surgery were selected. All patients were randomly divided into I-gel laryngeal mask group (group I) and tracheal intubation group (group E, n = 20). The hemodynamic parameters at different time points after implantation, including mean arterial pressure (map), heart rate (HRT) and pulse oxygen saturation (SPO _ 2), were recorded, and PETCO _ (2), peak airway pressure (Ppeak) and airway seal pressure were recorded. Results there was no significant difference in the success rate of tracheal intubation (laryngeal mask) between the two groups, but the time of laryngeal mask placement in group I was significantly lower than that in group E (P 0.01). Compared with E group, MAPHR significantly decreased the level of T _ 3 in P _ (0.05) and T _ (1) T _ (3). Compared with group E, Pleak in group I was significantly lower than that in group E, and the incidence of adverse reactions after laryngeal mask removal in group I was significantly lower than that in group E (P 0.05). There was no reflux missuction in both groups. Conclusion I-gel larynx mask is used in general anesthesia of neonates undergoing laparoscopic surgery. Airway management can achieve the same ventilation effect as tracheal intubation. And the operation is convenient, the success rate is high, the complication is few.
【作者单位】：江西省儿童医院麻醉科;
【分类号】：R614

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