喉罩应用于老年高血压患者腹腔镜胆囊切除术的麻醉效果与安全性评价

目的观察一次性喉罩（Laryngeal mask airway,LMA）应用于老年高血压患者的麻醉效果与安全性。方法选择择期行腹腔镜胆囊切除术的老年高血压患者80例,ASAⅠ~Ⅱ级,分为喉罩组（A组）和气管内插管组（B组）各40例,观察记录两组患者诱导前5分钟（T0）、插管或置入喉罩后即刻（T1）、插管或置入喉罩后5分钟（T2）、气腹后（T3）、拔管或拔出喉罩时（T4）、拔管或拔出喉罩后5分钟（T5）,6个时间点的心率（HR）、收缩压（SBP）、舒张压（DBP）、心率与收缩压的乘积（RPP）、脉搏血氧饱和度（SpO2）、并观察插管或置入喉罩时、拔除前后及术中相关并发症,记录术后口咽痛、痰多或呛咳发生率。结果 T0时点两组患者HR、SBP、DBP、RPP及SpO2比较差异无统计学意义（P〉0.05）,T1与T4时点B组循环系统应急反应强于A组;两组T2与T3时点的HR、SBP、DBP、RPP比较差异有统计学意义（P〈0.05）;围术期A组呛咳、喉痉挛、术后咽痛、痰多等并发症少于B组（P〈0.05）。结论喉罩较支气管内插管全麻围手术期循环功能更加稳定,插管及拔管时呛咳、喉痉挛、术后咽痛、多痰等并发症更低。

Application of laryngeal mask airway in aged patients with hypertension undergoing laparoscopic cholecystectomy

Objective To observe the anesthetic effect and safety of disposable laryngeal mask（airway LMA）used in elderly patients with hypertension.Methods Eighty cases of elderly patients with hypertension scheduled for elective laparoscopic cholecystectomy,ASA Ⅰ~Ⅱ grade,were randomly divided into two groups：group A（LMA group）and group B（endotracheal intubation group）.We observed heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,rate-pressure product（RPP）,pulse oxygen saturation（SpO2）of the two groups of patients at 5 minutes before induction（T0）,immediately after intubation or laryngeal mask airway insertion（T1）,5 minutes after intubation or laryngeal mask airway insertion（T2）,after pneumoperitoneum（T3）,the time of pulling or unplugging laryngeal mask（T4）,5 minutes after extubation or laryngeal mask pulled（T5）,and related complications while intubating or inserting laryngeal mask and removing tube or laryngeal mask before and after surgery.Incidence of oral sore throat,phlegm or cough were recorded.Results HR,SBP,DBP,RPP,SpO2 at T0 of the two groups had no significant difference（P0.05）.The emergency reaction of circulatory system at T1 and T5 in group B patients was stronger than that in group A.Incidence such as perioperative coughing,laryngeal spasm,postoperative sore throat,phlegm and other complications in group A was significantly less than that in group B.Conclusion Patients in LMA group has more stable perioperative circulation,lower complications such as intubation and extubation cough,laryngospasm,postoperative sore throat and phlegm.