喉罩通气联合硬膜外阻滞在外科手术麻醉中的临床效果分析

目的评价喉罩通气联合硬膜外阻滞在外科手术中的麻醉优势。方法选择2009年1月～2011年9月行外科择期手术的患者80例,随机分为喉罩全麻复合硬膜外阻滞组和气管插管复合硬膜阻滞组各40例。手术过程中连续监测患者的血压(BP)、心率(HR)、心电图(ECG)、血氧饱和度(SPO2)、呼气末二氧化碳分压(PetCO2);记录拔除气管导管或喉罩时是否安静,患者有无呛咳、喉痉挛及呕吐,观察有无咽喉疼痛。结果全麻诱导后两组MAP和HR均较诱导期显著降低(P﹤0.05),插入导管或喉罩后:喉罩通气联合硬膜外阻滞组MAP和HR较诱导前差异无统计学意义(P﹥0.05),而气管插管复合硬膜外阻滞组MAP和HR较诱导前迅速升高(P﹤0.05),两组间比较差异有统计学意义(P﹤0.05);术中:两组MAP、HR值均较平稳,基本恢复至全麻诱导前,两组间比较差异无统计学意义(P﹥0.05);拔出导管或喉罩时:喉罩通气联合硬膜外阻滞组MAP和HR升高不明显,而气管插管复合硬膜外麻醉阻滞组升高则较诱导前显著升高(P﹤0.05),两组间比较差异有统计学意义(P﹤0.05)。喉罩通气联合硬膜外阻滞组安静拔管例数明显多于气管插管复合硬膜外阻滞组,不良反应前者也明显少于后者。结论喉罩通气复合硬膜外阻滞用于外科手术麻醉,麻醉效果好,可有效维持术中通气,术后并发症少,可广泛用于外科手术麻醉中。

Analysis of the clinical effect for laryngeal mask ventilation combined with epidural anesthesla in anesthesia surgery

OBJECTIVE To evaluate the advantages for laryngeal mask ventilation combined with epidural anesthesia in anesthesia surgery.METHODS 80 patients with line of elective surgery from January 2009 to September 2011 were chosen.They were randomly divided into laryngeal mask anesthesia combined with epidural anesthesia group with 40 cases and tracheal intubation combined epidural anesthesia group with 40 cases.Continuously monitored on patients during surgery including blood pressure(BP),heart rate(HR),electrocardiogram(ECG),oxygen saturation(SPO2),end-tidal carbon dioxide partial pressure(PetCO2);recorded whether it was quiet when extubation or laryngeal mask was given,patients with or without cough,laryngospasm and vomiting,observed with or without throat ache.RESULTS After induction of anesthesia,MAP and HR in the two groups were significantly lower(P﹤0.05),after catheterization and giving laryngeal mask,MAP and HR were not different in laryngeal mask ventilation combined with epidural anesthesia group before and after the induction(P﹥0.05).MAP and HR increased rapidly(P﹤0.05)in endotracheal intubation combined with epidural anesthesia groupafter induction,there was a significant difference between the two groups(P﹤0.05).During the surgery:the values of MAP and HR were stable,recovered from anesthesia before induction,the difference between the two groups was not significant(P﹥0.05).Removing the catheter or the laryngeal mask:increase of MAP and HR was not obvious in laryngeal mask ventilation combined with epidural anesthesia group,and which were significantly higher than before induction in endotracheal intubation anesthesia combined with epidural anesthesia group(P﹤0.05),there was a significant difference between the two groups(P﹤0.05).The number of cases with quiet extubation in laryngeal mask ventilation combined with epidural anesthesia group was significantly more than in tracheal intubation combined with epidural anesthesia group,the former adverse reactions was significantly less than the latter.CONCLUSION The effect of laryngeal mask airway combined with epidural block anesthesia for surgery is effective,can maintain intraoperative ventilation and fewer complications,can be widely used in surgical anesthesia.