【摘要】 目的:通过观察Supreme喉罩在腹腔镜胆囊切除术中的应用,探讨其安全性与优越性。方法:择期腹腔镜胆囊切除手术患者60例,ASAⅠ~Ⅱ级,随机均分为喉罩组(S组)和气管插管组(T组)。记录诱导前(T0)﹑插入喉罩/气管导管即刻(T1)﹑插入喉罩/气管导管3min(T2)和拔出喉罩/气管导管前3min(T3)﹑拔出喉罩/气管导管即刻(T4)﹑拔出喉罩/气管导管后3min(T5)的MAP、HR、SpO2、PET CO2;丙泊酚用量﹑苏醒和拔罩/管时间,以及术中胃胀气、反流误吸、术后咽喉部不适等并发症。结果:与T组比较,S组患者在麻醉诱导和苏醒阶段(T1~T4)的HR减慢,MAP降低,血流动力学更加平稳(P<0.05)。S组丙泊酚用量降低,苏醒时间、拔喉罩时间缩短(P<0.05)。S组有2例患者术中气道阻力升高,PET CO2升高至60mmHg。术后咽喉不适S组(2例)明显少于T组(10例)(P<0.05)。结论:与气管插管比较,Supreme喉罩对血流动力学影响小,麻醉用药量减少,苏醒快且并发症少,是一种较为理想的全麻气道管理工具,但术中应监测PET CO2。更多还原

【Abstract】 Objective:To observe the application of supreme laryngeal mask airway in laparoscopic cholecystectomy, and explore its security and advantages. Methods:60 patients with elective laparoscopic cholecystectomy surgery, ASA Ⅰ ~ Ⅱ level, were randomly divided into two groups, laryngeal mask group(group S) and trachea intubation group(group T). MAP, HR, SpO2 and PET CO2 will be recorded before the induction(T0), at intubating LMA/tube instantly(T1), 3 min after intubating(T2) and 3 min before pulling out LMA/tube(T3), pulling out instantly(T4),3 min after pulling out(T5). Dosage of propofol, the time of waking up and pulling out LMA/ tube were be recorded. And complications, such as intraoperative flatulence, reflux and aspiration postoperative, throat discomfort were also recorded. Results:Compared with, HR, MAP in group S were significantly lower at T1 ~ T4, and dosage of propofol in group S were lower. Time of waking up and pulling out LMA in group S were lower than group T(P < 0.05). But intraoperative airway pressure and PET CO2 of 2 patients increased to 60 mmHg in group S. Incidence of postoperative throat discomfort in group S(2 cases) was obviously less than group T(10 cases)(P < 0.05). Conclusion:Compared with endotracheal intubation, supreme LMA is one of ideal airway management tools, because it can make more stable hemodynamics, reduce dose of propofol and complications during anesthesia, but PET CO2 should be monitored perioperatively.更多还原