喉罩全麻和气管插管全麻在单孔胸腔镜肺叶切除术中的临床对照研究

发布时间：2019-08-19 12:29

【摘要】：目的:评估保留自主呼吸的喉罩全麻在单孔胸腔镜下肺叶切除术中应用的可行性。方法:喉罩组与双腔支气管组各20例肺占位行胸腔镜肺叶切除术淋巴结清扫术患者。两组均行肋间神经阻滞,术中喉罩组不使用肌松药,保留自主呼吸;双腔管组使用肌松药,术中行单肺通气。结果:喉罩组与双腔管组在手术时间、术中最低SpO_2、术前、术后1 h PaCO_2无明显差异。喉罩/双腔管放置满意用时、拔管时间、恢复室停留时间、术后住院时间喉罩组均短于双腔管组。插喉罩/双腔管前后,△MAP、△HR喉罩组低于双腔管组。术中每千克体重舒芬太尼、丙泊酚用量喉罩组显著少于双腔管组。肺叶切除后血气PaCO_2、术中最高PETCO_2,喉罩组显著高于双腔管组。术后咽喉痛发生率、住院总费用喉罩组低于双腔管组。结论:保留自主呼吸的喉罩全麻用于胸腔镜肺叶切除术具有明显优势。
[Abstract]:Objective: to evaluate the feasibility of laryngeal mask general anesthesia with spontaneous respiration in single hole thoracoscopic lobectomy. Methods: 20 patients with pulmonary space occupying space in laryngeal mask group and 20 patients in double lumen bronchus group were treated with thoracoscopic lobectomy. Intercostal nerve block was performed in both groups. Intraoperative laryngeal mask group did not use muscle relaxant to retain spontaneous respiration, and double lumen tube group was treated with muscle relaxant and intraoperative one-lung ventilation. Results: there was no significant difference in the operation time, the lowest SpO_2, before operation and 1 hour after operation between the laryngeal mask group and the double lumen tube group. When the laryngeal mask / double cavity tube was placed satisfactorily, the extubation time, the residence time of the recovery room and the postoperative hospitalization time of the laryngeal mask group were shorter than those of the double cavity tube group. The, MAP, HR laryngeal mask group was lower than the double lumen tube group before and after the insertion of throat cover / double lumen tube. The dosage of sufentanil and propofol per kilogram of body weight in laryngeal mask group was significantly lower than that in double lumen group. After lobecectomy, the highest PaCO_2, in PETCO_2, laryngeal mask group was significantly higher than that in double lumen tube group. The incidence of sore throat after operation, the total cost of hospitalization in the larynx mask group was lower than that in the double lumen tube group. Conclusion: general anesthesia with laryngeal mask with spontaneous respiration has obvious advantages in thoracoscopic lobectomy.
【作者单位】：青岛大学附属医院黄岛院区麻醉科;
【分类号】：R614

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