Supreme喉罩通气全麻在乳腺癌根治术中的应用

目的：评价Supreme喉罩通气全麻在乳腺癌根治术中的临床效果及安全性。方法：选择60例拟行乳腺癌根治术患者，随机分为Supreme喉罩组（LMA组）与气管插管组（GA组），每组30例，分别记录诱导前（T0）、给药时（T1）、置喉罩／气管导管即刻（T2）、置喉罩／气管导管后3min（13）、5min（T4）、切皮时（T5）、手术进行30min（T6）及拔除喉罩／气管导管即刻（T7）各时点患者血流动力学的变化，并观察拔除喉罩／气管导管后的不良反应。结果：与基础值（T0）相比，GA组在T1、T2、T3、T7各时点的HR、MAP变化均显著，而LMA组只在T1时点变化显著。组间比较，两组在T2、T3、T4、T7同时点的HR、MAP差异显著（P〈0．05），苏醒时间、拔管时间无明显差异。LMA组术后咽喉部不良反应明显少于GA组。结论：Supreme喉罩在乳腺癌根治术中气道管理方便，患者血流动力学改变及术后不适均优于气管插管全麻，且不影响患者的苏醒和拔管时间，具有重要的临床应用价值。

The clinical application of laryngeal mask airway unite fentanyl in the radical operation of mastocarcinoma

Objective：To evaluate the clinical application of laryngeal mask airway unite fentanyl in the radical operation of mastocarcinoma. Methods ：40 patients of mastocarcinoma were evenly randomized fall into 2 groups： laryngeal mask airway unite fentanyl （LMA） and endotraeheal intubation inhalation general anesthesia（ GA）, after using identical derivants, respectively record and aalyzed the different information between LMA group and GA group of their haemodynamics changes during preoperative period and The reactions of pars laryngea pharyngis when they regained consciousness. Results： In GA group, the HR and MAP were obviously increased than the base value at the time 1,3min after intubated; In LMA group, the HR and MAP were similarly to the base value after using laryngeal mask, the disparities between LMA and GA have the statistical significance （ P 〈 0.05 ）. After discontinuation, all of the patients of LMA were waked up in （9.2 ± 2.8 ） rain without appearing pain of pars laryngea pharyngis,it also has the statistical sig- nificance（P 〈0.01 ）. Conclusions： LMA is obviously outstrip CA in the radical operation of mastocarcinoma, and possess important value of clinical application.