喉罩与气管插管用于乳腺全麻手术的比较

目的比较喉罩和气管插管用于乳腺全麻手术对患者血流动力学、呼吸功能和麻醉并发症等方面的影响。方法将40例ASAI或Ⅱ级乳腺全麻手术患者，随机分为喉罩组、气管插管组，记录其潮气量（Vt）、气道压力（Pmax和Pmean）、呼气末二氧化碳分压（PETCO2）、脉搏氧饱和度（SpO2）、心率（HR）、收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP），并记录置入期、手术中、拔管期、术后24h麻醉相关并发症及患者苏醒时间、麻醉费用情况。结果置入即刻、置入后1min及拔管即刻，喉罩组HR、SBP、DBP、和MAP均显著低于气管插管组（P〈0．05），其他时点两组间比较差异无统计学意义（P〉0．05）。两组患者的Vt、Pmax，、Pmean、PETC02比较差异无统计学意义（P〉0．05）。喉罩组术中呛咳和苏醒期躁动例数低于气管插管组，漏气、咽痛例数明显高于气管插管组，差异均无统计学意义（P〉0．05）。清醒时间、定向力恢复时间、拔管时间及麻醉费用方面比较差异无统计学意义（P〉0．05）。结论全麻喉罩通气优于气管内插管，易于维持血流动力学稳定，麻醉后恢复平稳。

Comparison of laryngeal mask airway and endotreacheai intubation in patients undergoing mam-mary gland operation

Objective Tocompare tubation in general anesthesia of breast surgery effects ot laryngeal mask airway（ LMA ） and tracneaa m- on hemodynamics, respiratory function and anesthesia complications. Methods Forty patients（ ASA class Ⅰ or Ⅱ ）scheduled for selective mammary gland op- eration under general anesthesia were randomly divided into LMA group （ n = 20） and ET group （ n = 20） with mechnical ventilation. The hamodynamic changes was observed perioperatively, the different effects of ventilation and gas exchange, the different incidence of anesthetic complications and the anesthetic costs were observed in both groups. Results At once of intubation, 1 min after placement, tube drawing instantly, HR, SBP, DBP and MAP in LMA group were significantly lower than those in ET group （P 〈 0.05 ）, at the other point, there was no significant difference between the two groups （ P 〉 0.05 ）. There were no significant differences in Vt, Pmax, Pmean, PETCO2 between the two groups （P 〉0.05）. La-ryngeal mask set of intraoperative choking cough and awakening period disquieting casesunder ET group, leak, pharynx pain were significantly higher than that of ET group, there were no statis- tically significant differences （P 〉 0.05 ）. There were no significant differences in waking hours, direc- tional force anesthesia recovery time and extubation time and costs between the two groups （ P 〉 0.05 ）.