喉罩通气在小儿眼科手术麻醉中的应用

发布时间：2018-06-05 02:38

本文选题：喉罩 + 眼科手术　；参考：《重庆医学》2016年34期

【摘要】：目的观察喉罩应用于小儿眼科麻醉时的安全性、优越性。方法拟手术患儿60例,其中斜视41例,先天性白内障19例,年龄4~10岁,分为喉罩组(L组n=30)和气管插管组(T组n=30)。采用丙泊酚和瑞芬太尼诱导、维持麻醉。记录两组麻醉诱导及置入、拔出喉罩(气管导管,下同)即时、拔出后5min的心率(HR)、平均动脉压(MAP)变化。记录两组术中平均气道压(Pmean)、呼气末二氧化碳分压(PETCO2)。记录术毕拔除喉罩时间及躁动呛咳、喉痉挛、误吸、咽痛发生情况。结果 (1)T组在插入、拔出气管导管时MAP、HR较L组明显增高(P0.05),L组患儿各时间段MAP、HR均平稳(P0.05)。L组Pmean值低于T组,PETCO2两组差异无统计学意义(P0.05)。(2)L组拔出喉罩时间明显快于T组(P0.05)。L组躁动、呛咳及24h后仍然存在的咽痛等并发症发生率显著少于T组(P0.05),两组无喉痉挛及误吸病例出现。结论喉罩通气应用于小儿全身麻醉时,气道反应性低,血流动力学平稳,并发症少,是方便安全的通气方式。
[Abstract]:Objective to observe the safety and superiority of laryngeal mask in pediatric ophthalmic anesthesia. Methods Sixty children (41 strabismus and 19 congenital cataract aged 4 to 10 years) were divided into laryngeal mask group (n = 30) and tracheal intubation group (n = 30). Propofol and remifentanil were used to induce anesthesia. Anesthesia induction and placement were recorded, laryngeal mask (tracheal catheter) was removed immediately, heart rate (HR) and mean arterial pressure (map) of 5min were recorded immediately after pulling out. Mean airway pressure, end expiratory carbon dioxide partial pressure and PETCO _ 2 were recorded in both groups. Record the time of removal of larynx mask and the occurrence of restless cough, laryngeal spasm, aspiration and sore throat. Results when trachea catheter was inserted and pulled out, the Pmean HR of group T was significantly higher than that of group L (P 0.05). The Pmean value of group P 0.05 was lower than that of group T (P 0.05). There was no significant difference between two groups. The time of pulling out larynx mask in group T was significantly faster than that in group T (P 0.05) and restlessness in group L (P < 0.05). The incidence of throat pain and other complications in group T was significantly lower than that in group T (P 0.05). There were no laryngeal spasm or aspiration in both groups. Conclusion laryngeal mask ventilation is a safe and convenient ventilation method for children under general anesthesia with low airway reactivity, stable hemodynamics and less complications.
【作者单位】：徐州医学院附属第三医院麻醉科;
【分类号】：R726.1

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