欧普乐喉罩在腹腔镜肝癌射频消融术全麻中的临床应用

目的：评价欧普乐喉罩通气在腹腔镜肝癌射频消融术全麻中应用的安全性和可行性。方法：选择40例择期全麻腹腔镜肝癌射频消融术患者,ASAⅡ～Ⅲ级,按随机数字表法分为欧普乐喉罩组（A组）和气管内插管组（B组）各20例。观察记录两组患者在麻醉诱导前（T0）、插入喉罩或气管导管前（T1）、插入喉罩或气管导管后即刻（T2）、插入喉罩或气管导管后5 min（T3）、拔除喉罩或气管导管后即刻（T4）,5个时间点的收缩压（SBP）、舒张压（DBP）、心率（HR）与脉搏血氧饱和度（SpO2）。并记录麻醉相关并发症。结果：B组T1与T4时点的SBP、DBP和HR水平均明显高于A组,差异均有统计学意义（P〈0.05）;A组呛咳、苏醒期躁动、术后咽痛、痰多等并发症明显少于B组,差异均有统计学意义（P〈0.05）。结论：欧普乐喉罩通气应用于腹腔镜肝癌射频消融术,较气管内插管全麻围术期循环功能更加稳定,麻醉相关并发症更少。

Clinical Application of OPLAC-LMA During General Anesthesia Undergoing Laparoscopic Radiofrequency Ablation for Hepatic Carcinoma

Objective：To investigate the safety and feasibility of OPLAC-LMA ventilation during general anesthesia undergoing laparoscopic microwave ablation for hepatic carcinoma. Method：Forty patients with hepatic carcinoma for elective laparoscopic microwave ablation,ASAⅡ-Ⅲ grade, were randomly divided into two groups,20cases in each group.Ventilation was performed with OPLAC-LMA（the group A） or tracheal intubation（the group B）. The systolic blood pressure（SBP）, diastolic blood pressure（DBP）,heart rate（HR）,pulse oxygen saturation（Sp02）of patients before anesthesia induction（T0）, before（T1） and immediately after（T2） and 5 minutes after（T3） intubation or OPLAC-LMA insertion, the time of extubation or OPLAC-LMA pulled（T4） were observed.Related anesthesia complications were recorded. Result：SBP, DBP and HR at T1 and T4 in the group B patients were significantly higher than those in the group A, the differences were statistically significant（P〈0.05）.Incidence such as cough,emergence agitation,postoperative sore throat and phlegm and other complications in the group A were significantly less those that in the group B, the differences were statistically significant（P〈0.05）. Conclusion：Application of OPLAC-LMA ventilation undergoing laparoscopic microwave ablation for hepatic carcinoma,has more stable perioperative circulation,lower related anesthesia complications than that of tracheal intubation during general anesthesia.