喉罩通气下全身麻醉在腹腔镜阑尾切除术中的应用

目的探讨喉罩通气下全身麻醉在腹腔镜阑尾切除术中的应用价值。方法106例采用腹腔镜阑尾切除术患者，在知情同意情况下按入院单双号随机分为喉罩组和插管组各53例，两组患者均采用全身麻醉前常规快速诱导，吸氧3—5min，喉罩组置入喉罩进行全身麻醉，插管组应用气管插管下全身麻醉，术中按全身麻醉常规进行，比较两组术中生命体征变化及并发症发生情况。结果插管组在麻醉后5rain时的HR、MAP在术中及麻醉停止后5min时与喉罩组比较差异均有统计学意义（t=7．823、6．849、15.331、17．636，均P〈0．05），其余时点两组MAP和HR差异均无统计学意义（均P〉0．05）。两组均未发生拔管时返流误吸以及恶心呕吐等并发症，喉罩组躁动发生率5．7％、呛咳发生率9．4％、声音嘶哑发生率1．9％均明显低于插管组的32．1％、34．0％、17．0％（X^2=10．415、7．996、5．410，均P〈0．05）。结论喉罩通气下全身麻醉与插管下全身麻醉在腹腔镜阑尾切除术中具有同样的麻醉效果，对生命体征影响均较小，且喉罩通气下全身麻醉中并发症发生率较低。

Application of laryngeal mask airway anesthesia in laparoscopic appendectomy

Objective To investigate the effect of general anesthesia of laryngeal mask airway in laparoscopic appendectomy;Methods 106 cases of laparoscopic appendectomy patients in the informed consent were randomly divided into LMA group and intubation group by odd and even numbers of hospital,53 cases per group,all patients were used of rapid induction of general anesthesia,oxygen 3 ～ 5min,laryngeal mask insertion laryngeal mask anesthesia,intubation group received tracheal intubation under general anesthesia,then compared of both groups in vital signs and complications; Results HR and MAP of intubation group 5min after intubation was statistically significant from during anesthesia and anesthesia stopped 5 min ( t = 7. 823,6. 849,15. 331,17. 636, all P ＜ 0. 05 ), MAP and HR of other point had no significant difference ( P ＞ 0. 05 ). Regurgitation and aspiration, and complications such as nausea and vomiting had not been observed,emergence agitation in the LMA group was 5.7% ,cough was 9. 4% ,hoarseness was 1.9% all were significantly lower than the intubation group( x2 = 10. 415,7. 996,5. 410, all P ＜ 0. 05 ). Conclusion Laryngeal mask airway under general anesthesia with intubation in the laparoscopic appendectomy had the same anesthetic effect and it's impact on vital signs were small ,and it had a lower incidence of complications.