喉罩通气全麻在乳腺癌手术中的应用

目的观察喉罩通气全麻在乳腺癌手术中应用的安全性及可行性。方法 40例ASAI-Ⅱ级择期行乳腺癌手术患者,随机分为喉罩组（L组）和气管插管组（T组）,每组20例。两组患者均采用持续静脉泵注瑞芬太尼和丙泊酚维持麻醉。记录麻醉前、诱导后、置入时、置入后5min、拔管（罩）前、拔管（罩）时、拔管（罩）后5min的心率（HR）、有创血压（MAP）、脉搏氧饱和度（SpO2）,并记录置入期、拔管（罩）期、术后24h的相关并发症。结果 L组在喉罩置入、拔罩期间与诱导前、拔罩前比较,HR、MAP变化差异无统计学意义;T组在插管、拔管期间分别较诱导前、拔管前及L组HR明显增快、MAP明显升高（P〈0.05或P〈0.01）;L组苏醒期躁动及术后咽喉不适发生率明显少于T组（P〈0.05）。结论喉罩通气全麻用于乳腺癌手术,操作简便,应激反应小,通气满意,且咽喉并发症少,安全可靠。

Application of laryngal mask airway in general anesthesia during breast surgery

Objective To evaluate the safety and efficacy of laryngal mask airway（LMA）used in general anesthesia during breast surgery.Methods 40 ASA status I-II patients with breast cancer who underwent surgery were randomly divided into two groups to receive remifentanil-propofol general anesthesia,through LMA（group L）or tracheal intubation（group T）respectively.The hemodynamic variables during operation,the relative complications in 24h after operation were recorded.Results The MAP and HR maintained stable after LMA insertion and removing in group L,but increased significantly（P〈0.05 or P〈0.01）in group T,compared with the time point before tracheal intubation or extubation.The occurrences of disturbance during recovery period and discomfort in throat after surgery were less in group L than group T.Conclusion The laryngal mask airway can be safely used in general anesthesia undergoing breast cancer surgery.Compared with tracheal intubation,LMA can be easily inserted,with less cardiovascular responses and less discomforts about throat.