喉罩通气在妇科腹腔手术全麻中的应用

目的探讨喉罩通气与气管插管麻醉在妇科腹腔镜手术应用的安全性和可行性。方法选择80例择期妇科腹腔镜手术患者,随机分为喉罩组（LMA）和气管插管组（TI）,每组40例。比较入室后（T0）、麻醉诱导后（T1）、喉罩置入或气管插管即刻（T2）、气腹后20 min（T3）、拔除喉罩或气管导管前即刻（T4）和拔除喉罩或气管导管后即刻（T5）的收缩压（SBP）、舒张压（DBP）和心率（HR）,观察气腹前后的气道压力（PAW）变化,并比较麻醉苏醒期的不良反应。结果两组气腹后气道压力较气腹前明显增高（P〈0.05）。LMA组患者T2、T3、T4、T5时间点的SBP、DBP和HR低于TI组,差异具有显著性统计学意义（P〈0.05）。LMA组患者苏醒期躁动发生率（6.8%）明显低于TI组（42.5%）（P〈0.05）。结论喉罩通气麻醉用于妇科腹腔镜手术,安全性较高,优于气管插管。

Application of laryngeal mask airway in gynecological laparoscopic surgery

Objective To investigate the safety and feasibility of laryngeal mask airway（LMA） and tracheal intubation（TI） in gynecological laparoscopic surgery.Methods All of 80 cases of patients who would take gynecological laparoscopic surgery were selected and randomly divided into LMA group and TI group.There was 40 cases in every groups,systolic pressure（SBP）,diastolic blood pressure（DBP） and heart rate（HR） were contrasted after getting in operating room（T0）,and anesthesia induction（T1）,when inserting laryngeal mask airway and tracheal intubation（T2）,in 20 min after inserting laryngeal mask airway and tracheal intubation（T3）,before and after pulling out laryngeal mask airway and tracheal intubation（T4 and T5）.The pressure of airway（PAW） were observed between before pneumoperitoneum and after pneumoperitoneum.adverse reaction were contrasted in convalescent period between LMA group and TI group.Results PAW was increased significantly after pneumoperitoneum in both groups（P〈0.05）.The SBP,DBP and HR were significantly lower in LMA group than in TI groups in all time,the difference was significant in statistics（P﹤ 0.05）.The incidence rate of restlessness in convalescent period was lower in LMA groups（6.8%） than in TI groups（42.5%）（P〈0.05）.Conclusion Laryngeal mask airway anesthesia has higher safety in gynecological laparoscopic surgery,and was better than Tracheal intubation anesthesia.