经喉罩全凭七氟醚吸入全麻在小儿腹腔镜疝修补术中的应用

目的探讨小儿腹腔镜疝修补手术中使用喉罩全凭七氟醚吸入麻醉的效果及安全性。方法选择40例2～10岁腹腔镜疝修补手术患儿,随机分成喉罩(LMA)组和气管插管(TT)组,采用8%浓度七氟醚诱导后,置入喉罩或气管插管全凭吸入七氟醚全麻。观察围麻醉期的MAP、HR、SPO2、PETCO2变化及并发症情况。结果两种方法都能满意地完成手术的麻醉,LMA组在置入期和拔除期HR、MAP的变化较TT组小(p<0.05和p<0.01),两组的SPO2、PETCO2变化差异无显著性(p>0.05),LMA组苏醒期躁动、咽喉不适并发症的发生率少于TT组(p<0.01)。结论经喉罩全凭七氟醚吸入全麻应用于小儿腹腔镜疝修补手术中,具有置入方便、应激反应小、通气满意、安全可靠的优点。

THE APPLICATION OF ENTIRELY SEVOFLURANE INHALATION ANESTHESIA BY THE LARYNGEAL MASK IN PEDIATRIC LAPAROSCOPIC HERNIA REPAIR SURGERY

Objective Explore the effect and safety of entirely sevoflurane inhalation anesthesia by the laryngeal mask in pediatric laparoscopic hernia repair surgery.Methods Select 40 cases of 2 10-year-old children with laparoscopic hernia repair surgery,and randomly divide into laryngeal mask airway（LMA） and tracheal intubation（TT） group,place laryngeal mask or endotracheal tube after 8% concentration sevoflurane induction,then only by inhaled sevoflurane anesthesia.Observe perianesthesia MAP,HR,SPO2,PETCO2 changes and complications.Results Two kinds of methods can completed the anesthesia for operation with satisfaction,the changes of HR,MAP at implantation period and the extraction phase in LMA group were less than that in TT group（p〈0.05 and p〈0.01）,the changes of SPO2,PETCO2 in two groups there were no significant difference（p〉0.05）,the incidence of restlessness,throat discomfort complications at awake period in LMA group is less than that in TT group（p〈0.01）.Conclusion Under the condition of laryngeal mask airway ventilation smoothly,sevoflurane inhalation anesthesia can be used in pediatric laparoscopic hernia repair surgery.with the advantages of convenient placement,less stress reaction,ventilation satisfactory and safety