【摘要】 目的比较可弯曲喉罩(FLMA)联合静脉麻醉在颈动脉内膜剥脱术(CEA)中的应用效果。方法 60例CEA手术患者,随机均分为喉罩组(F组)和气管插管组(R组)。麻醉诱导后,分别植入喉罩或气管导管进行机械通气,记录植入和拔除喉罩(气管导管)前后MAP,HR和BIS。记录不同时点Ppeak,PETCO2,异丙酚,瑞芬太尼用量,术后苏醒时间、麻醉拔管时间;记录术中知晓、呛咳、咽痛、恶心、呕吐、声音嘶哑的情况。结果与R组比较,F组插入及拔除喉罩后MAP,HR更平稳;不同时点Ppeak,PETCO2差异无统计学意义;与R组比较,F组瑞芬太尼,丙泊酚总量减少(P<0.05),苏醒时间、拔管时间缩短(P<0.05)。结论 FLMA喉罩可以安全用于颈动脉内剥脱术(CEA)的麻醉中,可达到气管导管相同的通气效果,且减少麻醉药物用量,减轻血流动力学波动,降低不良反应发生率。更多还原

【Abstract】 Objective To compare the effect of the application of flexible laryngeal mask airway(FLMA)combined with intravenous anesthesia in carotid endarterectomy(CEA).Methods 60 patients were randomly divided into laryngeal mask group(Group F)and endotracheal intubation group(Group R).After induction of anesthesia,the laryngeal mask airway or endotracheal tube was inserted into mechanical ventilation,and MAP、HR、BIS were recorded before and after the laryngeal mask airway(trachea canal)was inserted and pulled out.Record Ppeak、PetCO2、Remifentanil dosage、Propofol dosage at different time points,and record awake time、extubation time;Record the intraoperative awareness in the postoperative follow-up records and the condition of cough、sore throat、nausea、hoarseness.Results It showed that compared with Group R,MAP and HR are more stable in Group F after insertion and removal of laryngeal mask;Ppeak and PetCO2 at different time points had no statistical significance;It showed that compared with Group R,the dosage of Remifentanil and Propofol decreased(P<0.05),awake time and extubation time are shortened in Group F(P<0.05).Conclusion FLMA can be safely used for carotid endarterectomy operation,it can achieve the same ventilation effect as the endotracheal intubation,and it can not only lighten hemodynamic responses,but also the amount of narcotic drugs,then it can reduce the incidence of adverse reactions.更多还原