ProSeal喉罩通气全麻在高血压患者腹腔镜胆囊切除术中的临床应用

目的观察高血压病人腹腔镜胆囊切除术中应用ProSeal喉罩通气全麻对患者血压和心率的影响。方法高血压腹腔镜胆囊切除术患者120例,ASAⅠ～Ⅱ级,随机分为喉罩组和气管插管组,每组60例。记录诱导前（T0）、置入喉罩/插管前即刻（T1）、置入喉罩/插管后1min（T2）、3min（T3）、胆囊切除时（T4）、拔喉罩或拔管时（T5）6个时间点的HR、MAP、BIS,并进行组间比较。结果气管插管组于插管后1min、3min、拔管时均较麻醉前、插管前即刻及喉罩组HR明显增快、MAP明显升高;瑞芬太尼、顺势阿曲库铵消耗总量、术毕24h内咽喉疼痛例数气管插管组要明显高于喉罩组,胃管置入比例两组则无明显差异。结论喉罩通气全麻在高血压病人腹腔镜胆囊切除术中可有效预防心血管应激反应,避免血压和心率的剧烈波动。

Application of ProSeal Laryngeal Mask Airway on Hypertension Patients Under Laparoscopic Cholecystecomy

Objective To evaluate the use of ProSeal laryngeal mask airway（PLMA） on hypertension patients under general anesthesia and laparoscopic cholecystecomy.Methods 120 hypertension patients（ASA I or II class） under LC were randomly allocated to either PLMA group（n=60） or endotracheal intubation（ETT） group（n=60）.HR,mean arterial pressure（MAP） and Bispectral Index（BIS） were recorded before anaesthesia（T0）,at the time of LMA /ETT（T1）,1 minute（T2） and 3 minute（T3） after LAM /ETT,during cholecysectomy（T4） and extubation（T5）.Results For the ETT group,HR and MAP were significantly higher at T2,T3 and T5 than the other time points.The consumption of Propofol /Remifentanil or Cisatracurium,the percentage of patients with sore throat at 24 hours post-operation in ETT group was significantly higher than the PLMA group.The proportion of setting stomach tube was not significantly difference between the two groups.Conclusion General anesthesia with PLMA can prevent hemodynamic effect and avoid the fluctuation of blood pressure and HR in hypertension patients.