双管喉管与双管喉罩用于全身麻醉患儿通气效果的比较

目的 比较双管喉管与双管喉罩用于全身麻醉患儿的通气效果.方法 拟行全身麻醉的患儿40例,ASAⅠ～Ⅱ级,随机分为双管喉管组(L组)和双管喉罩组(P组),每组20例.采用咪唑达伦0.05 mg/kg、丙泊酚1～2 mg/kg、芬太尼2～4 μg/kg和阿曲库胺0.5 mg/kg进行麻醉诱导,待肌松完全后插入适宜型号的双管喉管或双管喉罩.记录插入时间和一次插入成功率;术中持续监测的脉搏氧饱和度(SpO2)、心率(HR)、气道峰压(Ppeak)和呼气末二氧化碳分压(PETCO2),间隔3分钟测量并记录一次无创血压;记录手术时间、清醒时间、拔除时间和术后24 h内咽部不良反应的发生情况.结果两组插入时间和一次插入成功率比较差异均无统计学意义(P＞0.05);两组血流动力学平稳,SpO2、Ppeak和PETCO2 均在正常范围内,且差异均无统计学意义(P＞0.05);两组手术时间、清醒时间、拔除时间和术后24 h内咽部不良反应发生率比较差异无统计学意义(P＞0.05).结论双管喉管可以安全而有效地用于全身麻醉患儿,且通气效果与双管喉罩相似.

Comparison of ventilation efficacy through the laryngeal tube-suction airway and ProSeal laryngeal mask airway during anesthesia in pediatric patients

Objective To compare the ventilation through the laryngeal tube-suction airway(LTSA) and ProSeal laryngeal mask airway(PLMA) during anesthesia in pediatric patients.Methods Forty ASAⅠ-Ⅱ pediatric patients underwent elective general surgery were randomly divided into two groups: group LTSA(group L) and group PLMA(group P).Anesthesia was induced with midazolam 0.05 mg/kg,propofol 1-2 mg/kg,fentanyl 2-4 μg/kg and atracurium 0.5 mg/kg.LTSA and PLMA were inserted when muscles were completely relaxed after anesthesia induction.The insertion time,the successful insertion rate at first attempt was recorded.MAP and HR were recorded and monitored interval 3 min.SpO2,peak airway pressure(Ppeak) and PETCO2 were continuously monitored during anesthesia.The duration of operation,recovery time,extubation time and the pharyngeal adverse responses within 24 hours after operation were recorded.Results The insertion time,the successful insertion rate at first attempt had no significant difference between the two groups(P>0.05).SpO2,Ppeak and PETCO2 of the two groups were within normal limits,and there was no significant difference betwee the two groups.The mean arterial pressure,heart rate,the duration of operation,recovery time,extubation time and the pharynged adverse responses within 24 hours after operation in the two groups had no significant difference.Conclusion Laryngeal tube-suction airway can be safely and effectively used in pediatric patients,there is no difference in ventilatory effects between the two groups.