喉罩在腹腔镜手术麻醉中运用的必要性

杜如飞; 丁伟星; 刘云松; 张灿华

喉罩在腹腔镜手术麻醉中运用的必要性

1. 曲靖市第二人民医院麻醉科
2. 曲靖市第一人民医院麻醉科

基金项目:

基金：国家自然科学基金资助项目 (81160035);

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出版历程
- 收稿日期: 2017-05-14

Necessity of Application of Laryngeal Mask Airway in Laparoscopic Anesthesia

Funds:

基金：国家自然科学基金资助项目 (81160035);

摘要

摘要: 目的比较喉罩与气管插管在腹腔镜手术麻醉中的应用, 分析喉罩在腹腔镜手术麻醉中的运用必要性与临床应用效果.方法选取2013年1月至2016年12月曲靖市第二人民医院麻醉科收治的需行腹腔镜手术麻醉的患者76例为对象, 按照随机数字表将其分为气管插管组 (n=38) 及喉罩组 (n=38) , 气管插管组患者一次性气管导管, 喉罩组采用I-GEL喉罩, 全程观察、记录并比较2组患者麻醉诱导前 (T1) 、插管 (罩) 即刻 (T2) 、气腹即刻 (T3) 、气腹后10 min (T4) 、停止气腹 (T5) 、拔管 (罩) 即刻 (T6) 6个时点的HR、MAP、PETCO2、苏醒时间以及术后苏醒期躁动、拔管时呛咳、术后咳嗽、咽喉痛和声嘶等不良反应发生率.结果喉罩组各个时点的HR、MAP值明显低于气管插管组, 2组患异者PETCO2差无统计学意义 (P>0.05) ;喉罩组的苏醒时间为 (5.12±3.82) min明显短于气管插管组的 (10.14±4.15) min (P<0.05) ;I-GEL喉罩组的不良反应发生率为5.26%, 气管插管组的不良反应发生率为23.68% (P<0.05) .结论在腹腔镜手术麻醉过程中, 采用I-GEL喉罩, 诱导及苏醒期血流动力学平稳, 术后苏醒时间短以及术后苏醒期躁动、拔管时呛咳、术后咳嗽、咽喉痛和声嘶等不良反应发生率明显减少.术中通气状况良好, 安全性较高, 且患者舒适度、满意度高.具有比较好的应用价值, 值得推广.
- I-GEL喉罩 /
- 腹腔镜手术麻醉 /
- 必要性 /
- 临床应用效果
Abstract: Objective To analyze the necessity and clinical application of laryngeal mask airway anesthesia in laparoscopic surgery through comparing the efficacy of laryngeal mask airway and endotracheal intubation in laparoscopic surgery. Methods We selected 76 patients undergoing laparoscopic surgery in the Department of Anesthesiologyin Qujing Second People's Hospital From January 2013 to December. According to the random number table, the patients were divided into tracheal intubation group (n =38) and laryngeal mask group (n=38) . Tracheal intubation group was given disposable tracheal catheter, laryngeal mask group was given I-GEL laryngeal mask. Then the patients in the 2 groups were observed and compared in 6 points of HR, map, PETCO2, recovery time and postoperative restlessness, extubation cough, cough after surgery, the incidence of adverse reactions and hoarseness and sore throat, such as before induction of anesthesia (T1) , immediate intubation (cover) (T2) , pneumoperitoneum (T3) , at 10 min after pneumoperitoneum (T4) , pneumoperitoneum (T5) , stop extubation immediately (cover) (T6) . Results The HR and MAP values in laryngeal mask group at each time point was significantly lower than those in tracheal intubation group, there was no significant difference in PETCO2 between the 2 groups of patients (P >0.05) .The recovery time of patients in laryngeal mask group was (5.12±3.82) min, significantly shorter than that in the intubation group which was (10.14±4.15) min (P <0.05) . The incidence of adverse reaction in I-GEL laryngeal mask group was 5.26%, The incidence of adverse reactions in the tracheal intubation group was 23.68% (P <0.05) .Conclusion During laparoscopic anesthesia with I-GEL laryngeal mask airway, patients have stable hemodynamics in induction and recovery period, short postoperative recovery time, and low incidence of adverse reactions such as postoperative restlessness, extubation cough, postoperative cough, sore throat and hoarseness. The ventilation condition of patients during the operation is good and I-GEL laryngeal mask airway has higher safety, comfort and satisfaction degree, so it has good application value and deserves promoting.
- I-GEL laryngeal mask /
- Laparoscopic anesthesia /
- Necessity /
- Clinical application effect

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参考文献(15)

[1]潘子鹏, 李闻.腹腔镜阑尾切除术治疗急性阑尾炎的临床疗效及其安全性评价[J].昆明医科大学学报, 2016, 37 (8) :119-122.
[2]曹德钧, 祖存.不同全麻方式在老年高血压患者行单孔腹腔镜胆囊切除术的比较[J].昆明医科大学学报, 2015, 36 (9) :98-101.
[3]章敏, 崔中璐, 疏树华, 等.I-gel喉罩与Supreme喉罩在腹腔镜肾脏手术中的应用比较[J].临床麻醉学杂志, 2014, 30 (04) :370-373.
[4]马甫营, 王胜斌.气管插管与i-gel喉罩在腹腔镜手术麻醉中的应用比较[J].安徽医药, 2014, 18 (8) :1574-1576.
[5] 曹江北, 王鹏, 米卫东, 等.腹腔镜手术患者i-gel喉罩气道管理的效果[J].军医进修学院学报, 2012, 33 (4) :362-363, 366.
[6]胡胜红, 王胜斌, 居霞, 等.超声引导下髂腹下髂腹股沟神经阻滞对i-gel喉罩通气在腹腔镜小儿疝修补术中麻醉效应的影响[J].实用医学杂志, 2015, 31 (5) :859-860.
[7]肖少华, 王伶俐, 吴健, 等.I-gel喉罩在妇科腹腔镜手术全麻苏醒期的应用效果评价[J].湖北医药学院学报, 2015, 34 (03) :270-273.
[8]冯洁华, 李朝阳, 陈超, 等.Proseal、Supreme和I-gel三种双管喉罩用于妇科腹腔镜麻醉的气道管理比较[J].中国现代手术学杂志, 2015, 19 (04) :315-318.
[9]孟剑.I-gel喉罩用于腹腔镜异位妊娠手术患者气道管理的效果[J].中国当代医药, 2011, 18 (14) :78-79.
[10]李小锋.喉罩在小儿眼科手术麻醉中的临床应用观察[J].现代临床医学, 2011, 37 (1) :61-62.
[11]唐苏红, 张建友, 孙建宏, 等.Supreme喉罩与i-gel喉罩在小儿腹腔镜手术气道管理中的应用[J].海南医学, 2016, 27 (24) :4105-4106, 4107.
[12]胡玲, 康路, 王瑞婷, 等.I-gel喉罩与Supreme喉罩在小儿腹腔镜手术中的应用比较[J].实用医学杂志, 2016, 32 (13) :2245-2246.
[13]	[13]SRIVASTAVA A, TYAGI P.Comparison of I-gel and LMA-Supreme Laryngeal Mask Airway in Laparoscopic Surgery:A Prospective Randomized Study[J].Indian Journal of Public Health Research&Development, 2013, 4 (3) :298-298.
[14]	[14]SARDI A S D C, BRITTO M, RANGEL J.Comparison of Postoperative Throat and Neck Complaints after the Use of the i-Gel versus the Traditional Laryngeal Mask[J].Open Journal of Anesthesiology, 2013, 3 (4) :233-236.
[15]	[15]BERINGER R M, KELLY F, COOK T M, et al.A cohort evaluation of the paediatric i-gel (TM) airway during anaesthesia in 120 children[J].Anaesthesia, 2011, 66 (12) :1121-1126.

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