I-gel喉罩全麻对介入手术患者机体应激反应的影响

目的使用I—gel喉罩进行介入手术的全身麻醉，研究对手术患者机体应激反应的影响。方法60例介入手术患者，随机分为两组（n=30），常规气管插管组（E组），I-gel喉罩组（I组）。麻醉诱导后，分别置入气管插管和I—gel喉罩。于麻醉前（T，）、插管后（T2）、麻醉苏醒后（L）、及术后24h（T4），各时间点记录循环和呼吸变化，并抽取静脉血标本，用放射免疫法检测血浆皮质醇（Cor），血管紧张素（AngII）水平变化。结果I组较E组在T2和T3时点的BP和HR明显降低（P〈0．05），差异有显著性。在T2、T3时，I组患者Cor水平明显低于E组（P〈0．05），在L时，I组患者Angll水平明显低于E组（P〈0．05）。结论I-gel喉罩全麻能有效地降低机体手术创伤和心理应激反应影响，血液动力学稳定性好，具有安全性和可行性。

Effects of laryngeal mask airway I-gel general anesthesia on the stress response during interventionalsurgery

Objective To observe the effect of laryngeal mask airway I-gel for interventional surgery on stress reaction. Methods Under general anesthesia to choose 60 eases patients of interventional surgery, were randomize into 2 groups （n =30 eaeh）, intubation group （group E）, LMA I-gel group （group I）. After induc- tion of anesthesia endotracheal tube and LMA I-gel were inserted in grounp E and I respectively. Hemodynamics and respiration changes were monitored and recorded before inducion （ T1 ）, after intubation （ T2 ）, after re- moved the tube （ T3 ） and 24hrs after operation （ T4 ）. The 5ml samples of venous blood were collected at T1 , T2,T3, T4. The levels of cortisol and angiotensin II in the plasma were measured by RIA. Results BP and HR were significantly lower in the group I than in group E at T2 and T3 （ P 〈 0.05 ）. Cortisol was significantly lower in the group I than in group E at T2 and T3 （ P 〈 0.05 ）. Ang II were significantly lower in the group I than in group E at T3 （ P 〈 0.05 ）. Conclusion Laryngeal mask airway I-gel anesthesia can effectively reduce the in- fluence of the operation trauma and psychological stress reaction, and it earl be used effeetively for interventional surgery.