【摘要】 目的 探讨喉罩往小儿舌系带矫正手术全身麻醉中的应用。方法 择期行小儿舌系带矫正手术患儿42例。所有患儿均采用静吸复合麻醉,术中应用喉罩通气。监测入室后麻醉前(T0)、麻醉诱导后患识和眼睑反射消失时(T1)、喉罩置入后即时(T2)、术中3~5分钟(T3)、术毕拔出喉罩时(T4)5个时间点患儿生命体征。记录每例患儿喉罩首次置入成功率和喉罩置入失败改为其他通气方式的比例。记录术中喉罩有无移位情况及术后24小时咽痛不适的发生情况。结果42例患儿喉罩首次置入成功36例,成功率为85.71%。术中喉罩均未发生漏气、移位,通气良好。术中患儿生命体征平稳。术后24小时咽痛6例,发生率为15%。T0时心率与T1、T2、T3、T4比较,差异有统计学意义(P<0.05)。T1、T2、T3、T4间两两比较,差异无统计学意义(P>0.05)。术中喉罩存在的两个时点(T2、T3)呼气末二氧化碳正压与喉罩不存在的3个时点(T0、T1、T4)比较,差异有统计学意义(P<0.05)。入室麻醉前T0时点与麻醉后T1、T2和T3三个时点平均动脉压力比较,差异均有统计学意义(P<0.05)。T1和T4时点平均动脉压力比较,差异有统计学意义(P<0.05,)。所有患者脉搏氧饱和度均在95%以上。结论 喉罩应用于小儿舌系带矫正手术的全身麻醉,安全性高,术中麻醉维持平稳,术后并发症少,安全可行。更多还原

【Abstract】 Objective To discuss the feasibility of application of laryngeal mask airway(LMA) in pediatric corrective surgery of lingual frenum.Methods Retrospective study was conducted of 42 children using laryngeal mask airway in selective surgical correction of lingual frenum under general anesthesia in our hospital.The childrens vital signs were recorded at five different time points:baseline before anesthesia(TO),consciousness and eyelid reflex disappear just after anesthesia induction(Tl),time right after the LMA insertion(T2),3~5 min after beginning of operation(13),and time at the extubation(T4).The success rale of first LMA insertion and the number of changing to other ventilation way were recorded.The shift of LMA and postoperative sore throat within 24 h were recorded.Results The success rate of the first LMA insertion was 85.71%.Intraoperative laryngeal mask airway leak and shift did not occur and the ventilation was also good.Vital signs of the children were stable during operation.The incidence of postoperative sore throat was 15%within 24 h.As to the heart rate,the vital signs of baseline TO were significantly different from other lime points(Tl,T2,T3,T4).After the anesthesia,there were no significant differences in heart rate among different lime points(T1,T2,T3,T4).Compare with T2 and T3,the values of partial end expiratory pressure of CO2 at T0,T1,and T4 were significantly different.Compare with T0,the values of mean arterial pressure at T1,T2 and T3 were significantly different,but there was a significant difference in mean arterial pressure between Tl and T4.As to the pulse oxygen saturation,all the values were above 95%.Conclusion Laryngeal mask airway is a supraglottic airway management method.The advantages of fewer haemodynamic changes and postoperative complication are confirmed.It is feasible and safe for securing the airway in surgical correction of lingual frenum.更多还原