SLIPA喉罩与气管插管在乳腺癌根治术中的应用比较

目的 比较SLIPA喉罩与气管插管在乳腺癌根治术中的应用效果,并评价其有效性和安全性.方法 随机选取60例乳腺癌患者分为SLIPA喉罩组(S组)和气管插管组(T组).分别记录插管或置罩成功率及所需时间,记录患者入室时(T0)、置罩或插管即刻(T1)、置罩或插管后3 min( T2)、拔罩或管前(T3)、拔罩或管即刻(T4)、拔罩或管后3 min(T5)的平均动脉压(MAP)、心率(HR))、脑电双频指数(BIS)变化.记录气道建立成功后10 min、30 min、60 min的气道峰压(Ppeak)、呼气末二氧化碳分压(PetCO2)和血氧饱和度( SpO2).并记录术中及术后并发症的发生情况.结果 T组气管插管所需时间明显长于S组置入SLIPA喉罩所需时间(P＜0.05).T1、T2、T4、T5时T组MAP明显高于T0及S组,HR明显快于T0及S组(均P＜0.05).S组在各时点MAP、HR差异均无统计学意义(均P＞0.05).两组患者各时点Ppeak、PetCO2、BIS均在正常范围内,差异均无统计学意义(均P＞0.05).术后咽痛、呛咳及躁动人数S组少于T组(均P＜O.05),两组均无反流、误吸发生.结论 SLIPA喉罩操作简捷,对血流动力学影响小,术后并发症少,能安全有效地用于乳腺癌根治术的麻醉.

Comparison of the streamlined liner pharynx airway and endotreacheal intubation in the radic mastectomy under general anesthesia

Objective To compare the effects of streamlined liner pharynx airway（SLIPA） and endotracheal intubation in the radical mastectomy under general anesthesia,and to evaluate the efficacy and safety.Methods Sixty patients scheduled for radical mastectomy were randomly divided into 2 groups.SLIPA group（S,n=30） and endotracheal intubation group（T,n=30）.The data were kept regarding the insertion time and successful rate,MAP,HR,BIS were recorded at 6 time points：before induction（T0）,during SLIPA incursion or trachel intubation（T1）,3min after intubation（T2）,before extubation（T3）,after extubation（T4）,3 min after extubation（T5）.Ppeak,PetCO2 and SpO2 were measured after successful airway placement at 10min,30min,60min and to observe intraoperative and postoperative throat complications.Results The time of endotracheal intubation group is significantly longer than SLIPA group（P＜0.05）.In group T,MAP and HR at T1,T2,T4,T5 were higer than at T0 and the same time points in group S（all P＜0.05）.No regurgitation and aspiration was found in two groups（all P＞0.05）.The incidence of complication in group T is significantly higher than that in group S（all P＜0.05）.Conclusion SLIPA is easier placement,safety and efficacy when it is used for the radical mastectomy under general anesthesia without significant influences on hemodynamics and fewer complications of throat after operation.