喉罩在小儿麻醉中的应用

目的探讨喉罩与气管导管在小儿麻醉中的使用方法及利弊。方法选择40例择期手术患儿随机分为两组,即喉罩组(LMA组,20例)和气管插管组(TT组,20例),全麻诱导给予咪达唑仑0.05mg/kg,芬太尼2.0ug/kg,丙泊酚1.0mg/kg,司可林1.0mg/kg,在药物完全起效后行LMA和TT置入。分别记录两组患儿麻醉诱导前、LMA(TT)置入前、置入后以及术后拔除LMA(TT)后的MAP、HR、SpO2的数值,并对置入LMA和TT的一次成功率进行比较。结果两组患儿在麻醉诱导前及LMA(TT)置入前的MAP、HR、SpO2值相比较无显著差异(P>0.05),而在置入后和术后拔除LMA(TT)时LMA组的MAP、HR显著低于TT组(P<0.05)。结论喉罩通气装置使用简单、无创伤,对大多数成人和小儿都适用。若掌握好喉罩使用的适应证和禁忌证,在小儿麻醉中的应用值得推广。

Laryngeal Mask Airway in Paediatric Anaesthetic Practice

Objective To comparison of the advantage and the disadvantage between tracheal tube (TT) and laryngeal mask airway (LMA) in pediatric anaesthetic practice. Methods Forty children scheduled for elective surgical intervention were randomized to be ventilated with LMA (n=20) and TT (n=20). Anesthesia was induced with midazolam (0.05 mg/kg), fentanyl (2.0 μg/kg), propofol (1.0 mg/kg) and scoline (1.0 mg/kg). MAP, HR and SpO2 were measured before induction of anesthesia, before and after insertion of LMA (TT) and after removal of LMA (TT). Results There were no significant deferences in MAP, SpO2 and HR of all the patients before the process (P>0.05), while in the time after the placement and the removal of LMA or TT, MAP and HR of LMA group were significantly lower than that of TT group (P<0.05). Conclusion LMA can be widely used in both adult and pediatric anesthesia for its easy operation and non-invasion.