可弯曲喉罩与气管插管在眼外科手术中的应用比较

Use of flexible laryngeal mask airway in ophthalmic surgery

关键词:  可弯曲喉罩  气管插管  血流动力学  通气功能

Key words:  Flexible Laryngeal Mask Airway  tracheal intubation  hemodynamics  respiratory function

摘要:

[目的]评价可弯曲喉罩在眼科手术中患者血流动力学、呼吸功能及并发症的情况。[方法] 60名患者随机分为两组，可弯曲喉罩组（F组）和气管插管组（T组）各30例，麻醉诱导采用咪唑安定，芬太尼，依托咪酯、顺式阿曲库铵。F组插入可弯曲喉罩，T组插入气管插管，然后机械通气。分别于麻醉诱导前（T0），插入可弯曲喉罩或气管插管前（T1），插入后1 min（T2）, 5 min（T3）,拔出喉罩或气管插管前（T4）,拔后1 min（T5）,5 min（T6）记录SBP、DBP和HR；分别于插入可弯曲喉罩或气管插管后即刻（T1），30 min（T2）,60 min（T3）,90 min（T4）, 拔出喉罩或气管插管前（T5）记录气道峰压（Ppeak）、PetCO2和SpO2；并观察拔管期间并发症，烦躁、恶心、咽痛、呛咳、返流情况。[结果]T组T2时SBP、DBP、HR均较T1时显著升高[JP]（P<0.05），T5时SBP、HR均较T4时显著升高（P<0.05），组间比较T2时SBP、DBP、HR，T5时SBP、HR T组显著高于F组。F组在T1-T5期间SBP、DBP、HR无明显变化。两组Ppeak、PetCO2组内组间比较差异均无显著性意义。T组与F组比较，烦躁、呛咳发生率升高，P<0.05。[结论]与气管插管相比，眼科手术使用可弯曲喉罩可使血流动力学更加平稳，通气功能良好，并发症更少。

Abstract:

[Objective]To investigate the Use of flexible laryngeal mask airway (LMA) in ophthalmic surgery on hemodynamics, respiratory function and perioperative complications. [Methods]Sixty patients scheduled for ophthalmic surgery were randomized into 2 groups, flexible LMA (F) group and tracheal intubation (T) group. Tracheal tube or FLMA was inserted and the patients were mechanically ventilated. SBP, DBP, HR were recorded before induction of anesthesia (T0), before insertion of Tracheal tube or FLMA (T1), after insertion at1 min (T2), 5 min (T3), and before removal of Tracheal tube or FLMA (T4), after removal at1 min (T5), 5 min (T6) separately. Ppeak, PetCO2 and SpO2 were recorded after insertion of Tracheal tube or FLMA immediately (T1), at 30 min (T2), 60 min (T3), and 90 min (T4) before removal of tracheal tube or FLMA (T5). Complication such as dysphoria, vomiting, sore throat, cough, and regurgitation were also recorded.[Results] In tracheal tube group, SBP, DBP, HR at T2 were significantly higher than that at T1 （P<0.05）and SBP, HR at T5 were higher than that at T4 （P<0.05）. SBP, DBP, HR at T2， SBP, HR at T5 in tracheal tube group were significantly higher that at T2 in FLMA group. SBP, DBP, HR had no significantly change in FLMA group. Ppeak，PetCO2 in every group and between two groups had no significantly change. The rate of dysphoria and coughing in tracheal tube group were higher than that in FLMA group（P<0.05）. [Conclusion]The use of FLMA in ophthalmic surgery can make hemodynamic more stable, ventilation good, and fewer perioperative complications.