i-gel喉罩用于腹腔镜胆囊手术患者气道管理的效果

目的 评价i-gel喉罩用于腹腔镜胆囊手术患者气道管理的效果.方法 择期全麻下拟行腹腔镜胆囊手术患者120例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄34～62岁,体重45～90 kg,随机分为2组(n=60):ProSeal喉罩组(P组)和i-gel喉罩组(Ⅰ组).根据体重选择喉罩型号,麻醉诱导后置入喉罩,行机械通气,并经引流管放置胃管.记录喉罩置入次数、喉罩及胃管置入情况、纤支镜检查评分,测定喉罩密封压,观察术中口咽部漏气、低氧血症的发生情况.术中监测SpO2、PETCO2、气道峰压,观察拔除喉罩后恶心、呕吐、呛咳、声嘶、咽喉痛、返流误吸的发生情况,记录麻醉时间、手术时间、拔除喉罩时间及苏醒时间.结果 两组麻醉时间、手术时间、拔除喉罩时间及苏醒时间差异无统计学意义(P＞0.05).两组术中SpO2、PETCO2、气道峰压均在正常范围内.与P组比较,Ⅰ组喉罩首次置入成功率和纤支镜检查评分升高,喉罩置入时间缩短(P＜0.05).两组喉罩和胃管置入成功率均为100%;Ⅰ组和P组喉罩密封压比较差异无统计学意义(P＞0.05);Ⅰ组咽喉痛发生率低于P组(P＜0.05),恶心呕吐、呛咳发生率差异无统计学意义(P＞0.05),两组无一例发生声嘶、返流误吸.结论 i-gel喉罩易于置入,气道密封性可靠,通气效果好,不良反应少,可安全有效地用于腹腔镜胆囊手术患者的气道管理.     

Supreme喉罩和Proseal喉罩用于腹腔镜手求患者气道管理的比较体会

目的：比较Supreme和Proseal喉罩用于腹腔镜手术患者的气道管理。方法：择期全麻下腹腔镜手术患者60例。随机分为S（Supreme喉罩）组和P（Proseal喉罩）组。记录喉罩置入时间．置入次数及胄管置入情况。分别记录置入喉罩后1min．5min及置入胃管5rain时的SpO2．SBp．DBp．Hr．气道峰压。结果;两组各时点的SpO2．SB-．DBe．Hr．PETCO2．Peak之间无统计学差异。S组置入喉罩时间短于P组喉罩置入时间．其中1次置入成功率91％．2次成功率100％。两组拔喉罩后不良反应的发生率之间无统计学差异。结论：Supreme喉罩置入快速．通气效果好．拔除后不良反应少,可安全有效地用于腹腔镜手术患者的全麻气道管理。     

SaCo可视喉罩和Supreme喉罩用于腹腔镜手术的比较

目的 观察SaCo可视喉罩和Supreme喉罩在腹腔镜手术中的效果。
方法 选择择期行全麻下腹腔镜手术患者60例,男21例,女39例,年龄18～78岁,ASA Ⅰ—Ⅲ级。按照随机数字表法分为两组：Supreme喉罩组（S组）和SaCo喉罩组（K组）,每组30例。记录喉罩置入成功即刻、置入成功后1、2 h气道密封压、置入时间、首次置入成功例数、喉罩调整>2次的发生情况、置入成功即刻气道峰压、喉罩对位准确例数、胃管置入成功例数和喉罩拔除时间。
结果 喉罩置入成功即刻、置入成功后1、2 h K组气道密封压明显高于S组（P<0.05）,K组喉罩调整次数＞2次的发生率明显低于S组（P<0.05）,K组喉罩对位准确率明显高于S组（P<0.05）。两组喉罩置入时间、首次置入成功率、置入成功即刻气道峰压、胃管置入成功率、喉罩拔除时间差异无统计学意义。
结论 与Supreme喉罩比较,SaCo可视喉罩气道密封性、对位准确率高,可以安全有效地应用于腹腔镜手术的气道管理。     

I-gel喉罩与Supreme喉罩在腹腔镜肾脏手术中的应用比较

目的比较I-gel喉罩与Supreme喉罩在侧卧位腹腔镜肾脏手术中的应用效果。方法静脉全麻下侧卧位腹腔镜肾脏手术患者80例,随机均分为两组,分别使用I-gel喉罩(I组)和Supreme喉罩(S组)通气。记录首次插入成功率、插入时间、平卧位和侧卧位纤维支气管镜检查评级情况以及手术时间、苏醒时间、拔除喉罩时间;记录麻醉前(T1)、喉罩插入成功后5min(T2)、侧卧位后5min(T3)、气腹建立后20min(T4)、术毕时(T5)的气道峰压(Ppeak)及气道密封压(Pleak);记录患者咽喉部损伤情况。结果 I组中喉罩首次插入成功率为92.5%,明显高于S组的72.5%(P0.05);I组插入时间为(0.8±0.4)min,明显短于S组的(1.4±0.6)min(P0.05);I组纤维支气管镜评级优于S组(P0.05),S组平卧位时纤维支气管镜评级优于侧卧位(P0.05),I组Pleak明显高于S组(P0.05)。术毕时I组咽喉部疼痛发生率明显低于S组(P0.05)。结论 I-gel喉罩和Supreme喉罩用于侧卧位腹腔镜肾脏手术麻醉中均可有效通气,前者具有插入更方便快捷、插入成功率高、不需气囊充气、气道密封好及损伤小等优点。     

妇科手术患者Guardian喉罩与Supreme喉罩气道管理效果的比较

目的 比较Guardian喉罩与Supreme喉罩用于妇科手术患者气道管理的效果.方法 择期全麻下行妇科手术患者120例,年龄19～80岁,体重50～70kg,ASA分级Ⅰ或Ⅱ级,随机分为2组:Supreme喉罩组(S组,n=59)和Guardian喉罩组(G组,n=61).麻醉诱导后置入4号喉罩,行机械通气.术中监测BP、HR、SpO2、PETCO2和Ppeak.记录喉罩置人情况、置入时间、纤维支气管镜检查分级、气道密封压、正常通气时(VT 8 ml/kg)的气道压、大潮气量(VT20 ml/kg)通气试验时的气道压和漏气的发生情况、术中口咽部漏气的发生情况、拔除喉罩时不良反应和术后咽喉部不良反应的发生情况、麻醉时间、手术时间、喉罩拔除时间和苏醒时间.结果 两组喉罩置入成功率、置入时间、正常通气时的气道压、大潮气量通气试验时的气道压、拔除喉罩时罩体带血和术后咽喉疼痛、声音嘶哑和吞咽困难的发生率、麻醉时间、手术时间、喉罩拔除时间和苏醒时间差异无统计学意义(P＜0.05).两组患者BP、HR、SpO2、Ppeak和PETCO2均在正常范围内.与S组比较,G组纤维支气管镜检查分级和气道密封压升高,大潮气量通气试验时漏气和术中口咽部漏气的发生率降低(P＜0.01).结论 Guardian喉罩和Supreme喉罩置入简单易行,气道密封效果好,可有效保证通气,对咽喉部的刺激小.Guardian喉罩用于妇科手术患者气道管理的效果更好.     

腹腔镜手术患者CLMA喉罩、SLIPA喉罩与PLMA喉罩气道管理的效果

目的 比较经典型喉罩(CLMA喉罩)、SLIPA喉罩和食管引流型喉罩(PLMA喉罩)用于腹腔镜手术患者气道管理的效果.方法 择期行腹腔镜手术患者123例,年龄20～64岁,ASA分级Ⅰ或Ⅱ级,随机分为3组:CLMA组(C组,n=41)、SLIPA组(S组,n=42)和PLMA组(P组,n=40).麻醉诱导后置入喉罩,行间歇正压通气.测定气道密封压后实施气腹.评估喉罩置入难易性.记录首次喉罩置入情况、喉罩置入时间、麻醉恢复时间和不良反应的发生情况.于气腹前及气腹压至12 mm Hg时记录气道吸气峰压(PIP)及气道密封压＜PIP的发生情况.结果 C组有1例患者更换喉罩型号后置入成功,其余患者均首次喉罩置入成功,组间比较差异无统计学意义(P＞0.05).与C组比较,S组喉罩置入时间和麻醉恢复时间缩短,喉罩置入容易,P组喉罩置入时间延长,气道密封压升高,气道密封压＜PIP的患者减少(P＜0.05).与S组比较,P组喉罩置入时间和麻醉恢复时间延长,喉罩置入稍难,气道密封压升高,气道密封压＜PIP的患者减少(P＜0.05).与气腹前比较,各组气腹至12 mm Hg时PIP升高(P＜0.05).三组患者不良反应发生率比较差异无统计学意义(P＞0.05).结论 CLMA喉罩、SLIPA喉罩和PLMA喉罩均可保证有效通气,不良反应少.SLIPA喉罩置入更简单,而PLMA喉罩气道密封效果好,更适用于腹腔镜手术患者.     

LMA Supreme和i-gel喉罩用于全麻乳腺手术气道管理的比较

目的比较LMA Supreme喉罩和i-gel喉罩用于全麻乳腺手术患者术中气道管理的效果。方法选取全麻下行乳腺癌改良根治术患者60例,随机分为LMA Supreme喉罩组(A组)和i-gel喉罩组(B组)。记录两种喉罩的口咽腔漏气压、置入速度、置入时间和首次置入成功率,并记录并发症的发生情况。结果 A和B组首次置入成功率分别为28例(93.3%)和27例(90.0%),喉罩成功置入时间分别为(30±14)和(32±13)s,口咽腔漏气压分别为(25±5)和(27±7)cm H2O;两组首次置入成功率、成功置入时间、口咽腔漏气压和咽痛的发生率差异无统计学意义。两组均未出现气道痉挛或误吸等并发症。结论 LMA Supreme喉罩和i-gel喉罩均可安全有效地用于全麻乳腺癌改良根治术中,两者气道管理效果相似。     

Supreme喉罩用于妇科腹腔镜手术患者气道管理的效果

目的 评价Supreme喉罩用于妇科腹腔镜手术患者气道管理的效果.方法 择期行妇科腹腔镜手术的患者80例,ASA分级Ⅰ或Ⅱ级,年龄40～64岁,体重50～70 kg,身高158～170 cm,Mallampatis分级Ⅰ或Ⅱ级,随机分为2组(n=40):Supreme喉罩组(S组)和ProSeal喉罩组(P组).麻醉诱导后置入喉罩,行机械通气,并经引流管置入胃管.记录手术时间、气腹时间、清醒时间、喉罩置入时间、喉罩及胃管置入情况;记录喉罩囊内压为60 cm H2O时的充气量和气道密封压,并采用纤维支气管镜进行通气罩咽部解剖结构显露分级;术中监测BP、HR、ECG、SpO2、PETCO2,记录术后咽喉部不良反应的发生情况.结果 两组手术时间、气腹时间、清醒时间比较差异无统计意义(P＞0.05).两组术中BP、HR、SpO2、PETCO2、气道峰压均在正常范围,组间比较差异无统计学意义(P＞0.05).与P组比较,S组喉罩一次置入成功率、胃管一次置入成功率升高,喉罩置入时间缩短,通气罩咽部解剖结构显露分级升高,术后喉罩带血的发生率降低(P＜0.05);两组喉罩置入成功率均为100%,喉罩置入成功率、气道密封压、喉罩充气量比较差异均无统计学意义(P＞0.05).结论 Supreme喉罩通气效果好,气道密封性可靠,易于置入,可安全有效地用于妇科腹腔镜手术患者的气道管理.     

Supreme喉罩用于腹腔镜手术患者气道管理的效果

目的 评价Supreme喉罩用于腹腔镜手术患者气道管理的效果.方法 择期全麻下行腹腔镜手术的患者120例,性别不限,年龄35～60岁,体重48～85 kg,ASA Ⅰ或Ⅱ级,Mallampatis Ⅰ～Ⅲ级,随机分为2组(n=60):Supreme喉罩组(S组)和气管插管组(T组).S组根据患者体重选择喉罩型号,麻醉诱导后置入喉罩,并经引流管放置胃管,T组在直接喉镜下行气管插管.记录气管插管或喉罩置入时间及置人情况;记录S组胃管置入状况和喉罩气道密封压,并行纤维支气管镜检查评分,以评价喉罩对位情况;记录术中SpO2、PrrCO2和气道峰压(Ppeak),记录拔除气管导管或喉罩后不良反应的发生情况;记录手术时间、麻醉时间、拔管时间和苏醒时间.结果 与T组比较,S组喉罩置入时间、拔管时间和苏醒时间缩短,拔除喉罩后低氧血症、呛咳、咽喉痛的发生率降低(P<0.05);两组均无返流误吸发生.各时点spO2、PETCO2、Ppeak均在正常范围内,组间比较差异无统计学意义(P>0.05).S组喉罩置入成功率和T组气管插管成功率比较差异无统计学意义(P>0.05),S组喉罩气道密封压为(25±4)cm H2O,喉罩对位准确率95%,胃管放置成功率100%.结论 Supreme喉罩通气效果好,气道密封性可靠,拔除后不良反应少,可安全有效地用于腹腔镜手术患者的全麻气道管理.     

i-gel喉罩用于神经介入术患者气道管理的效果

目的 评价i-gel喉罩用于神经介入术患者气道管理的效果.方法 择期行神经介入术患者40例,ASA分级Ⅰ或Ⅱ级,年龄20～60岁,体重指数＜30 kg/m2,随机分为2组(n=20):i-gel喉罩组(Ⅰ组)和ProSeal喉罩组(P组).TCI异丙酚和瑞芬太尼麻醉诱导后置入喉罩,行机械通气,维持PETCO2 35～40 mm Hg,SpO2 99%～100%.于麻醉诱导前、诱导后即刻、置入喉罩后1、3、5 min和拔除喉罩即刻,记录BP和HR;记录喉罩置入成功情况、置入时间、漏气压和气道峰压;记录喉罩置入与拔除过程中呛咳、喉痉挛、血迹残留、误吸的发生情况;术后24 h内随访患者咽痛、声音嘶哑、腹胀腹痛的发生.结果 两组患者BP和HR均在正常范围内.两组喉罩置入成功率、喉罩置入时间和气道峰压比较差异无统计学意义(P＞0.05).与P组比较,Ⅰ组漏气压、血迹残留和咽痛的发生率降低(P＜0.05).结论 i-gel喉罩置入简单易行,气道密封效果好,可有效保证通气,不良反应少,可安全地用于神经介入术患者的气道管理.     

i-gel喉罩用于妇科腹腔镜手术患者气道管理的效果

目的 评价i-gel喉罩用于妇科腹腔镜手术患者气道管理的效果.方法 择期全麻下拟行妇科腹腔镜手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄21～64岁,体重45～90 kg,Mallampatti分级Ⅰ～Ⅲ级,采用随机数字表法,将其随机分为2组(n=30):i-gel喉罩组(I组)和Supreme喉罩组(S组).根据体重选择喉罩型号,麻醉诱导后置入喉罩,经引流管放置胃管,行机械通气.记录喉罩置入时间、置入次数、胃管置入次数、喉罩密封压、纤维支气管镜检查分级、术中血液动力学指标、通气指标、麻醉时间和苏醒时间,记录拔除喉罩后咽喉痛、吞咽痛和声音嘶哑的发生情况.结果 两组麻醉时间、苏醒时间、喉罩置入时间、纤维支气管镜检查分级、术中血液动力学指标和通气指标差异无统计学意义(P>0.05).两组喉罩和胃管置入成功率均为100%.与S组比较,I组喉罩密封压升高,咽喉痛和吞咽痛发生率降低(P<0.05或0.01).结论 i-gel喉罩气道密封性可靠,并发症少,可安全有效地应用于妇科腹腔镜手术患者的气道管理.

Abstract：

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel used in patients undergoing laparoscopic gynecological surgery. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 21-64 yr, weighing 4590 kg, undergoing elective laparoscopic gynecological surgery, were randomized into 2 groups ( n = 30 each):LMA i-gel group (group Ⅰ) and LMA Supreme group (group S) . Mallampatti test was performed before operation in both groups. Anesthesia was induced with target-controlled infusion of propofol (target plasma concentration 2.5-4.0 μg/ml) and remifentanil (target plasma concentration 3-6 ng/ml) . After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA i-gel and LMA Supreme were inserted in I and S groups respectively. A gastric tube was inserted through the drain tube of the LMA. In group S the air was injected into the cuff to make intracuff pressure reach 60 cm H2O after successful LMA insertion. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of hemodynamics and ventilation, and complications (sore throat, odynopliagia,hoarseness) were recorded. The fiberoptic laryngoscopy scores were assessed after successful LMA placement. The anesthesia time and recovery time were also recorded. Results There was no significant difference in the anesthesia time, recovery time, LMA placement time, fiberoptic bronchoscopy scores and the parameters of hemodynamics and ventilation between the two group. The success rates of LMA and gastric tube placement were 100% in both groups. The airway sealing pressure was significantly higher, while the incidence of sore throat and odynopliagia was significantly lower in group I than in group S. Conclusion LMA i-gel provides adequate ventilation during operation with fewer complications and can be used effectively for gynecological laparoscopic surgery.     

Lower intracuff pressure of laryngeal mask airway in the lateral and prone positions compared with that in the supine position

We compared the intracuff pressure (ICP) of a laryngeal mask airway (LMA) in the lateral and prone positions with that in the supine position. One hundred and eight patients, weighing 50-70 kg, scheduled for elective orthopedic and plastic surgery, were assigned to three groups, based on their body position during surgery. General anesthesia was induced and then a size 4 deflated LMA was inserted in each patient in the supine (group 1; n = 42), lateral (group 2; n = 45), or prone position (group 3; n = 21). The LMA cuff was inflated with 15 ml of air. Anesthesia was maintained without nitrous oxide, and the ICP was measured until LMA removal in the supine position. ICP in groups 2 and 3 was significantly lower than that in group 1 from immediately after insertion to the end of surgery. After surgery, turning from the lateral (group 2) or prone (group 3) position to the supine position significantly raised the ICP. Because the ICP is related to the seal pressure of the LMA and postoperative pharyngolaryngeal morbidity, we recommend evaluating and adjusting the ICP appropriately in each body position.     

妇科腹腔镜手术患者双管喉管和双管喉罩通气效果的比较

目的 比较双管喉管和双管喉罩用于妇科腹腔镜手术的通气效果.方法 拟行妇科腹腔镜手术患者50例,ASA Ⅰ或Ⅱ级,体重指数＜30 kg/m2,随机分为2组(n=25),双管喉管组(L组)和双管喉罩组(P组).两组均靶控输注异丙酚(血浆靶浓度3～5 μg/ml)和瑞芬太尼(血浆靶浓度4～6 ng/ml),静脉注射维库溴铵0.1 mg/kg,待BIS40～60时置人适宜型号的双管喉管或双管喉罩,置入成功后应用纤维支气管镜观察口咽部解剖结构显露分级情况.记录双管喉管或双管喉罩置入时间、一次置人情况和气道密封压.术中持续监测HR、SP、DP、MAP、SpO2、气道峰压(Ppeak)和呼气末二氧化碳分压(PETCO2),记录手术时间、气腹时间、清醒时间、拔除时间及术后24 h内咽部不良反应发生情况.结果 两组置入时间、一次置入成功率、气道密封压、手术时间、气腹时间、清醒时间、拔除时间及术后24 h内咽部不良反应发生率比较差异均无统计学意义(P＞0.05).两组术中血液动力学平稳,SpO2、Ppeak和PETCO2均在正常范围,且差异无统计学意义(P＞0.05).与L组比较,P组纤维支气管镜下口咽部解剖结构更清晰(P＜0.01).结论 双管喉管可有效地用于妇科腹腔镜手术,安全性良好,其通气效果与双管喉罩无差异.     

The proseal laryngeal mask airway in prone patients: a retrospective audit of 245 patients

The use of the classic laryngeal mask airway (classic LMA) in the prone position is controversial, but the ProSeal laryngeal mask airway (ProSeal LMA) may be more suitable as it forms a better seal and provides access to the stomach. In the following retrospective audit, we describe our experience with the insertion of and maintenance of anaesthesia with, the ProSeal LMA in 245 healthy adults in the prone position by experienced users. The technique involved (1) the patient adopting the prone position with the head to the side and the table tilted laterally; (2) pre-oxygenation to end-tidal oxygen >90%; (3) induction of anaesthesia with midazolam/alfentanil/propofol; (4) facemask ventilation (5) a single attempt at digital insertion and if unsuccessful a single attempt at laryngoscope-guided, gum elastic bougie-guided insertion; (6) gastric tube insertion; (7) maintenance of anaesthesia with sevoflurane/O/N2O; (8) volume controlled ventilation at 8-12 ml/kg; (9) emergence from anaesthesia in the supine position; and (10) removal ofthe ProSeal LMA when awake. Facemask ventilation was always successful. ProSealLMA insertion was successful in all patients: 237 with digital insertion and eight with bougie-guided insertion. Ventilation was successful in all patients. Gastric tube insertion was successful in all patients. Correctable partial airway obstruction occurred in three patients, but there was no hypoxia, hypercapnoea, displacement, regurgitation, gastric insufflation or airway reflex activation. Our findings suggest that the insertion of and maintenance of anaesthesia with the ProSeal LMA is feasible in the prone position by experienced users.     

A multicenter study of the Ambu laryngeal mask in nonparalyzed, anesthetized patients

We designed this multicenter trial to evaluate the performance and safety of the Ambu laryngeal mask, a new disposable supraglottic airway device, in patients scheduled for elective surgery. One-hundred-eighteen nonparalyzed, anesthetized patients (ASA physical status I-II, age, 18-65 yr, body mass index, 18-30 kg/m(-2)) receiving total IV anesthesia were included in this study. After device insertion, fiberoptic position and oropharyngeal leak pressure were determined at an intracuff pressure of 60 cm H2O. Ease of ventilation was determined by controlling ventilation at 6 mL/kg tidal volume. Any complications were noted and recorded. Device placement was successful in all patients on the first or second attempt (92.4% or 7.6%, respectively) with an insertion time (removal of face mask until first tidal volume) of 44.9 +/- 37.91 s. Adequate ventilation was achieved in all patients and the vocal cords could be visualized by fiberoptic endoscopy in 91.5% of patients. Oropharyngeal leak pressures were 24.1 +/- 5.44 cm H2O. Blood was detected on the device in 8.5% of patients. Complications and patient complaints were minor and quickly resolved. The Ambu laryngeal mask is easy and quick to insert and provides a safe and efficient seal during positive pressure ventilation in nonparalyzed patients scheduled for elective surgery.     

i-gel喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的效果

目的 评价i-gel喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的效果.方法 择期全麻下拟行腹腔镜手术患者55例,性别不限,ASA分级Ⅰ～Ⅲ级,年龄26～64,体重54～73 kg,Mallampati分级Ⅰ～Ⅲ级,采用随机数字表法,将患者随机分为2组:经i-gel喉罩放置胃管组(Ⅰ组,n=28)和术前经鼻放置胃管组(Ⅱ组,n=27).Ⅰ组经i-gel喉罩的引流管放置胃管,并经胃管引流胃液及气体,Ⅱ组术前经鼻放置并术中保留胃管,麻醉诱导前充分吸引后,再置入喉罩.术中监测血液动力学指标、SpO2、PETCO2和气道峰压.置入成功后行纤维支气管镜检查评分,并观察胃管位移的发生情况;记录喉罩置入时间、首次置入成功情况、气道密封压、罩体周围漏气和胃管引流情况.拔除喉罩后观察罩体内是否有血液或返流物,记录术后24 h内咽部不良反应的发生情况.结果 两组术中血液动力学平稳,SpO2、气道峰压均在正常范围,气道峰压低于喉罩密封压,组间比较差异无统计学意义(P＞0.05);两组喉罩置入时间、首次置入成功率、胃管引流率、气道密封压、罩体漏气发生率、口咽部解剖结构显露评分、咽部不良反应发生率、罩体内带血和有返流物的发生率比较差异均无统计学意义(P＞0.05),Ⅱ组胃管均未发生位移.结论 对于术前置入鼻胃管的腹腔镜手术患者,i-gel喉罩易于置入,气道密封性可靠,通气效果好,不影响胃管引流,可安全有效地用于该类患者的气道管理.

Abstract：

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel in patients required insertion of nasogastric tube before laparoscopic surgery. Methods Fifty-five ASA Ⅰ - Ⅲ patients ( Mallampati Ⅰ -Ⅲ ), aged 26-64 yr, weighing 54-73 kg, scheduled for elective laparoscopic surgery were randomly divided into 2 groups: group Ⅰ ( n= 28) and group Ⅱ ( n = 27). The size of i-gel LMA was chosen based on the patient' s weight, and i-gel LMA was inserted after induction of anesthesia with TCI of propofol and remifentanil, and iv injection of rocuronium. In group Ⅰ , the nasogastric tube was inserted through the drain tube of i-gel LMA. In group Ⅱ , the nasogastric tube was inserted through the nostril before operation. The hemodynamic parameters, SpO2 ,PETCO2 and peak airway pressure were monitored during operation. The fiberoptic laryngoscopy scores were assessed and nasogastrice tube displacement was recorled after successful LMA placement. The LMA placement time, success rate of LMA placement at the first attempt, airway sealing pressure, the occurrence of air leakage of LMA, and nasogastric tube drainage were recorded. The problems after removal of the LMA were observed and the adverse reactions within 24 h after operation were recorded. Results The hemodynamics was stable and the SpO2,peak airway pressure were within the normal range during operation in both groups. There was no significant difference in the LMA placement time, success rate of LMA placement at the first attempt, nasogastric tube drainage rate, airway sealing pressure, incidence of air leakage, fiberoptic laryngoscopy scores, problems after removal of the LMA and adverse reactions between the two groups ( P ＞ 0. 05). Conclusion i-gel LMA can provide adequate ventilation and does not interfere with the nasogastric tube drainage during laparoscopic surgery and can be used effectively for the patients required insertion of nasogastric tube before operation.     

低套囊压力下ProSeal或Supreme喉罩用于腹腔镜手术患者气道管理的效果

目的 评价低套囊压力下ProSeal和Supreme喉罩用于腹腔镜手术患者气道管理的效果.方法 择期仰卧位腹腔镜手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄20～70岁,体重50～80 kg,随机分为ProSeal喉罩组(P组)和Supreme喉罩组(S组),每组30例.喉罩置入成功后,用手持测压计监测套囊充气压力并维持其为35 cm H2O,记录气道密闭压及气腹前后机械通气时气道压峰值和平均气道压,记录术后并发症的发生情况.结果 两组气腹后机械通气时气道压峰值高于气腹前(P＜0.05),两组间比较差异无统计学意义(P＞0.05);术中气腹前后均无漏气现象发生;两组气道密闭压比较差异无统计学意义(P＞0.05);两组拔除喉罩后表面带有血丝及术后咽痛发生率比较差异无统计学意义(P＞0.05).结论低套囊压力(35 cm H2O)下ProSeal和Supreme喉罩通气效果均较好,可安全地用于腹腔镜手术患者的气道管理.