口咽通气道联合面罩机械通气在患儿日间手术中的应用

发布时间：2018-03-11 02:21

本文选题：口咽通气道联合面罩　切入点：喉罩　出处：《临床麻醉学杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的探讨口咽通气道联合面罩通气在患儿日间手术中应用的有效性和安全性。方法100例日间手术患儿,年龄6~12岁,随机分为两组,分别采用口咽通气道联合面罩通气(M组)和喉罩通气(L组)。静脉输注瑞芬太尼及丙泊酚诱导,术中静脉持续输注瑞芬太尼、丙泊酚维持麻醉。术中维持通气RR 16~20次/分,调节VT,维持PETCO235~40mm Hg。记录诱导前(T1)、置入口咽通气道或喉罩时(T2)、手术开始时(T3)、麻醉用药减半时(T4)、停麻醉用药时(T5)、手术结束时(T6)、拔出口咽通气道或喉罩时(T7)的HR、MAP、SpO2、PETCO2、VT、BIS值及Ppeak。记录置入口咽通气道或喉罩一次成功率,停药至拔出口咽通气道或喉罩时间,自主呼吸恢复良好时间,患儿清醒时间,患儿术后不良反应发生情况。结果两组患儿全部成功完成手术。一次性插入的成功率M组明显高于L组(P0.05)。L组术中2例通气不佳,M组无通气不佳患儿。术后患儿有咽部不适感L组11例,M组2例。两组患儿术中HR、MAP、SpO2、PETCO2、VT、BIS值及Ppeak差异无统计学意义。两组PETCO2波形与正常波形比较无变化。术后不良反应及并发症L组明显高于M组(P0.05)。结论口咽通气道联合面罩下通气应用于患儿日间手术是安全有效的。
[Abstract]:Objective to investigate the efficacy and safety of oral and pharyngeal ventilation combined with mask ventilation in daytime surgery in children. Methods 100 children with daytime surgery, aged 6 to 12 years, were randomly divided into two groups. Remifentanil and propofol were induced by intravenous infusion of remifentanil and propofol respectively. The anesthesia was maintained by intravenous infusion of remifentanil and propofol. Adjust VT, maintain PETCO235~40mm Hg. record HRMAPSpO2PETCO2VTIS and Ppeak. before induction or larynx mask, T2, T3, T4, T5, T6, T7 and Ppeak. at the end of the operation, we can record the values of HRMAPSpO2PETCO2VTIS and Ppeak.At the end of the operation, we can record the values of HRMAPSpO2PETCO2VTIS and Ppeak.Then, we can find out the value of HRMAPSpO2PETCO2VTIS and Ppeakat at the end of the operation. The successful rate of placing oropharynx airway or laryngeal mask in a single time was recorded. The time from withdrawal of drug to the extraction of the oropharyngeal airway or larynx mask, the good time of spontaneous respiratory recovery, and the waking time of the child, Results the successful rate of one-off insertion in group M was significantly higher than that in group L (P 0.05). There was no significant difference in BIS and Ppeak between the two groups. There was no change in PETCO2 waveform between the two groups. The postoperative adverse reactions and complications in group L were significantly higher than those in group M (P 0.05). Oral-pharyngeal ventilation combined with mask ventilation is safe and effective for daytime surgery in children.
【作者单位】：首都医科大学附属北京儿童医院麻醉科;
【分类号】：R726.1

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