【摘要】 目的:探讨国产驼人喉罩在剖宫产术全麻气道管理中的有效性和安全性。方法:选择2013年至2014年在宜昌市妇幼保健院和宜昌市第一人民医院行静脉全麻下剖宫产术产妇160例,其中择期手术115例,急诊手术45例;年龄22~43岁,体质量52~94 kg,ASAⅠ或Ⅱ级。随机将产妇分为国产驼人喉罩组及气管插管组。手术过程中测量两组患者插管前、插管后、拔管前、拔管后的心率和平均动脉压,记录麻醉诱导完成移除面罩至插管的成功时间、麻醉诱导完成移除面罩至胎儿娩出时间、新生儿的Apgar评分、插管(喉罩)失败率、反流病例数、术后咽痛例数。结果:与喉罩组比较,气管插管组在插管后、拔管前、拔管后心率明显增快,平均动脉压明显升高(P<0.001),麻醉诱导完成移除面罩至插管的成功时间明显较长(P<0.001)。两组产妇麻醉诱导完成移除面罩至胎儿娩出时间和新生儿Apgar评分差异均无统计学意义(P>0.05)。两组没有发生反流。气管插管组术后咽痛发生16例,显著多于喉罩组的4例(χ2=8.229,P=0.004)。结论:国产驼人喉罩插入和拔除操作不会显著改变血流动力学,术后的不良反应较少,可以安全有效地用于剖宫产产妇全麻气道管理。更多还原

【Abstract】 Objective: To explore the effect of TuorenTMlaryngeal mask airway on cesarean section anesthesia.Methods: A total of 160 patients with American Society of Anesthesiologists( ASA) Ⅰ or Ⅱ foot of cesarean section in full-term pregnant women for the first time production of Yichang Women and Children’s Health Care Hospital and Yichang First People’s Hospital were recruited in 2013-2014. They were randomly divided into two groups,TuorenTMlaryngeal mask group and tracheal intubation group. Heart rate( HR) and mean arterial pressure( MAP)were observed before and after intubation and extubation. The successful time of removing the mask after anesthesia induction to intubation( laryngeal mask)( T1) and removing the mask after anesthesia induction to childbirth( T2),neonatal Apgar score,reflux cases,intubation( laryngeal mask) failure rate and postoperative adverse reactions such as sore throat were observed. Results: Compared with the laryngeal mask group,HR and MAP of intubation group increased significantly after intubation,and before and after extubation( P < 0. 001). T1 of intubation group was obviously longer( P < 0. 001). The differences of T2 and neonatal Apgar score between the two groups were not significant( P > 0. 05). No reflux cases occurred in the two groups. Sixteen patients in intubation group had postoperative sore throat,which was more significantly than 4 cases in laryngeal mask group( χ2= 8. 229,P =0. 004). Conclusion: The TuorenTMlaryngeal mask airway for caesarean section anesthesia had no obvious effect on hemodynamic changes and had less postoperative adverse reactions,which can be safely and effectively used in cesarean section patients for general anesthesia airway management.更多还原