喉罩在腹腔镜下胆囊切除术的应用

目的 观察喉罩通气在腹腔镜下胆囊切除术中的应用效果。方法 选择ASAI～II级择期行腹腔镜下胆囊切除术的患者70例,随机分为2组:喉罩组(A组)和气管导管组(B组)。分别记录诱导前(T₀)、插入喉罩/气管导管即刻(T₁)、气腹5 min时(T₂)、拔除喉罩/气管导管后即刻(T₃)的MAP、HR、SpO₂、Ppeak,并记录两组患者的苏醒时间、拔除喉罩/气管导管时间及术后不良反应(呛咳、咽喉痛、反流误吸、声嘶)。结果 A组T₁、T₃的血流动力学较B组稳定(P＜0.05),A组各时点Ppeak均低于B组(P＜0.05);两组患者的苏醒时间、拔除喉罩/气管导管的差异无统计学意义(P＞0.05);A组呛咳、咽喉痛的发生率明显低于B组(P＜0.05)。结论喉罩通气用于腹腔镜下胆囊切除术麻醉较气管导管血流动力学平稳、术后并发症少,是较理想的选择。

Clinical application of laryngeal mask airway to laparoscopic cholecystectomy

Objective To observe the clinical application of laryngeal mask airway(LMA) to laparoscopic cholecystectomy(LC).Methods 70 patients undergoing selective LC with ASA grade I to II were randomly assigned to LMA group(Group A) and endotracheal intubation group(Group B).MAP,HR,SpO₂ and Ppeak were recorded before anesthesia induction(T₀),intubation immediately(T₁),5 minutes after pneumoperitoneum(T₂),and extubation or laryngeal mask emigration immediately(T₃).In addition,the anesthesia recovery time,the extubation or laryngeal mask emigration time and postoperative complications(bucking,sore throat,reflux aspiration,hoarseness) of two groups were also recorded.Results The hemodynamics of T1 and T3 in group A were more stable than those in group B(P＜0.05).The values of Ppeak of T₀,T₁,T₂ and T₃ in group A were lower than those in group B(P＜0.05).There were no significantly differences in anesthesia recovery time and the extubation or laryngeal mask emigration time between two groups(P＞0.05).The incidences of bucking and sore throat in group A were significantly lower than that in group B(P＜0.05).Conclusion The application of LMA to LC has more stable hemodynamics and less postoperative complications than endotracheal intubation.So it may be a more ideal choice.