Supreme喉罩在腹腔镜胆囊切除术中的应用研究

目的：通过观察Supreme喉罩在腹腔镜胆囊切除术中的应用，探讨其安全性与优越性。方法：择期腹腔镜胆囊切除手术患者60例，ASAI～Ⅱ级，随机均分为喉罩组（s组）和气管插管组（T组）。记录诱导前（T0）、插入喉罩／气管导管即刻（T1）、插入喉罩／气管导管3min（T2）和拔出喉罩／气管导管前3rain（T3）、拔出喉罩／气管导管即刻（T4）、拔出喉罩／气管导管后3min（T0的MAP、HR、SpO2、PEICO2；丙泊酚用量、苏醒和拔罩／管时间，以及术中胃胀气、反流误吸、术后咽喉部不适等并发症。结果：与T组比较，S组患者在麻醉诱导和苏醒阶段（T1～T4）的HR减慢，MAP降低，血流动力学更加平稳（P〈0．05）。S组丙泊酚用量降低，苏醒时间、拔喉罩时间缩短（P〈0．05）。S组有2例患者术中气道阻力升高，PrrCO：升高至60mmHg。术后咽喉不适s组（2例）明显少于T组（10例）（P〈0．05）。结论：与气管插管比较，Supreme喉罩对血流动力学影响小，麻醉用药量减少，苏醒快且并发症少，是一种较为理想的全麻气道管理工具，但术中应监测PETICO2。

Application of Supreme laryngeal mask airway in laparoscopic cholecystectomy

Objective：To tomy, and explore its security observe the application of supreme laryngeal mask airway in laparoscopic cholecystec- and advantages. Methods：60 pati ASA I - II level, were randomly divided into two groups, laryngeal mask group （group S） and trachea intubation group（group T）. MAP, HR, SpO2 and PrrCO2 will be recorded before the induction（T0）, at intubating LMA/tube instant- ly（T1）, 3 min after intubating （T2） and 3 min before pulling out LMA/tube （T3）, pulling out instantly （T4）,3 min after pulling out（Ts）. Dosage of propofol, the time of waking up and pulling out LMA/tube were be recorded. And complica- tions, such as intraoperative flatulence, reflux and aspiration postoperative, throat discomfort were also recorded. Re- suits：Compared with, HR, MAP in group S were significantly lower at T1 - T4, and dosage of propofol in group S were lower. Time of waking up and pulling out LMA pressure and P~CO2 of 2 patients increased to in group S were lower than group T（P 〈 0.05）. But intraoperative airway 60 mmHg in group S. Incidence of postoperative throat discomfort in group S （2 cases） was obviously less than group T（10 cases） （P 〈 0.05）. Conclusion：Compared with endotracheal intu- bation, supreme LMA is one of ideal airway management tools, because it can make more stable hemodynamies, re- duce dose of propofol and complications during anesthesia, but PL-rCO2 should be monitored perioperatively.