喉罩和气管内插管在成人NUSS手术麻醉中的对照研究

目的比较喉罩通气与气管内插管在成人手术中气道管理的可行性和安全性。方法 60例拟行NUSS术的患者随机分为2组,每组各30例。喉罩组行喉罩气道管理,对照组行传统气管内插管。比较2组的麻醉药用量、麻醉效果、麻醉时间、术中血流动力学与生命体征变化、术后并发症等。结果喉罩组与插管组在麻醉及手术时间、术中呼末CO2峰值、麻醉满意度、失血量及出院时间差异无统计学意义（P〉0.05）。喉罩组手术前后白细胞、中性粒细胞百分比升高幅度、术中心率及平均动脉压变化幅度显著低于插管组（P〈0.05）,术后复苏时间、开始进食时间更短,且胃肠道反应、咽部不适感、声嘶发生率更低（P〈0.05）。结论成人VATS-NUSS手术的气道管理中,喉罩较气管内插管有一定优势。

Comparison of the effect of laryngeal mask airway and endotracheal intubation during NUSS procedure in adult patients

Objective To compare the feasibility and safety of video-assisted thoracoscopic surgery（VATS） for NUSS under laryngeal mask airway（LMA） or endotracheal intubation in adult patients.Methods Sixty patients were recruited for NUSS procedure and randomly divided into two groups.For the airway managements,one group was LMA and the other group was routine endotracheal intubation.Data were compared between two groups,which contained the dose of anesthesia,effect of anesthesia,time of anesthesia,variation of hemodynamics and vital sighs during the operation and complications.Results No significant differences were found between two groups about anesthetic time,surgery time,intraoperative peak Pet CO2,anesthetic satisfaction,blood loss or in-hospital stay.Compared with the endotracheal intubation group,the changes of WBC number,neutrophil percentage,HR and AMP were slight in the LMA group.Meantime,the postoperative awaking time and initial eating time were also shortened in the LMA group,along with a lower incidence of gastrointestinal reaction,throat discomfort and hoarseness.Conclusion LMA may show some advantages in air way management during VATS-NUSS procedure.