一次性喉罩在功能神经外科手术麻醉中的应用

目的探讨一次性喉罩与气管插管在功能神经外科手术麻醉中的风险与效益。方法将40例择期手术患者随机分配到喉罩组（LMA）和气管插管组（TT），每组各20例。全麻诱导给予咪达唑仑0.04mg/kg，芬太尼2μg/kg，依托咪酯0.15mg/kg，阿曲库铵0.8mg/kg后行LMA或TT置入。分别记录两组患者在麻醉诱导前（T0）、LMA（TT）置入前（T1）、置入后（T2）及拔除LMA（TT）后（T3）的平均动脉压（MAP）、心率（HR）和血氧饱和度（SpO2）数值，并对置入LMA和TT的一次成功率进行比较。结果两组患者在麻醉诱导前及LMA（TT）置入前的MAP、HR、SpO2值无显著差异（P〉0.05），而在置入后及拔除LMA（TT）时LMA组的MAP、HR显著低于TT组（P〈0.05）。结论在功能神经外科手术的麻醉中一次性喉罩的安全性优于气管内插管，值得推广。

The application of disposable laryngeal mask airway in functional neurosurgical anesthesia

Objective To explore the benefit and risk of disposable laryngeal mask airway （LMA） in functional neurosurgical anesthesia by comparing to endotracheal intubation （ETT）. Methods 40 elective surgery patients were randomly assigned to two groups, the LMA group and ETT group, with 20 patients in each group. All patients received 0.04 mg/kg of midazolam, 2 μg/kg of fentanyl, 0.15 mg/ kg of etomidate and 0.8 mg/kg of atracurium for induction and maintenance of general anesthesia. Mean arterial pressure （MAP）, heart rate （FIR） and oxygen saturation （SpO2） were recorded at following time points, before induction of anesthesia （TO）, before insertion （T1）, immediately after inserting ETT or LMA （T2） and at extraction （T3）. Additionally, the successful rates of first insertion for LMA and ETT were compared. Results There was no statistically significant difference in the MAP, HR and SpO2 at TO and T1 time points between the two groups （P 〈0.05）. However, the MAP and HR at T2 and T3 time points were significantly lower in LMA group compared to the ETT group（P〈0. 05）. Conclusions The disposable laryngeal mask airway has a better safety profile than endotracheal intubation in functional neurosurgical anesthesia and worthy of promotion.