SLIPA喉罩在腹腔镜胆囊切除手术麻醉中的应用

目的:评估SLIPA喉罩在腹腔镜胆囊切除手术麻醉中的应用效果,并探讨其安全性和有效性。方法:随机将行腹腔镜胆囊切除手术的患者分为两组:SLIPA喉罩组(S组)和经典喉罩组(C组)。分别记录喉罩成功置入率、一次放置成功所需时间以及术中需调整喉罩位置病例数;人工气道建立成功时、气腹后5min及气腹后30min时的气道峰压(Ppeak)、呼气末二氧化碳分压(PetCO2)和患者入室时(T1)、置入喉罩即刻(T2)、置入后3min(T3)、拔除喉罩即刻(T4)、拔除后3min(T5)的平均动脉压(MAP)、心率(HR);并观察术中有无胃胀气、返流误吸情况及术后咽喉部并发症,如声嘶或咽痛等。结果:两组患者在人工气道建立成功时、气腹后5min及气腹后30min时的Ppeak和PetCO2比较,差异均无统计学意义(P>0.05);同时两组患者在所选取的各时点的MAP和HR比较,差异无统计学意义(P>0.05);S组在一次放置成功率、一次放置成功所需时间以及术中需调整喉罩位置病例数方面优于C组,差异均有统计学意义(P<0.05)。两组术后各发生7例轻微咽痛,C组有4例患者术中发生胃胀气,两组均未见声音嘶哑及返流误吸。结论:SLIPA喉罩适用于腹腔镜胆囊切除手术,并发症少、操作便捷、安全性和有效性较高。

Application of SLIPA laryngeal mask airway to laparoscopic cholecystectomy under general anesthesia

Objective：To assess the clinical outcomes,safety and efficacy of SLIPA laryngeal mask airway in laparoscopic cholecystectomy under general anesthesia.Methods：Eighty ASA Ⅰ~Ⅱ adult patients scheduled to undergo laparoscopic cholecystectomy under general anesthesia were randomized into group of SLIPA laryngeal mask airway（group S,n=40）or conventional laryngeal mask airway（group C,n=40）.The data were kept regarding the insertion time and successful rate.Ppeak and PetC02 were measured by successful airway placement at respective 5 min and 30 min after pneumoperitoneum in the two groups besides recording of MAP and HR before anesthesia（T1）,successful airway placement（T2）,3 min after successful airway placement（T3）,laryngeal mask removal（T4）,3min after laryngeal mask removal（T5）,respectively.Side effects were also observed concerning intra-operative flatulence and backflow and post-operative throat soreness and hoarseness.Results：Ppeak and PetCO2 had no significant difference in each time point described above between the two groups（P0.05）,and MAP and HR remained no statistical difference（P0.05）.Group S appeared superior to group C with regard to successful placement,time consumption and intra-operative requirement of laryngeal mask correction（P0.05）.Minor pharyngodynia was found in 7 cases,respectively,in each group,and flatulence was reported in 4 in group C,but resulted in no hoarseness or backflow in the two groups.Conclusion：SLIPA laryngeal mask airway appears practical in laparoscopic cholecystectomy under general anesthesia for its fewer complications,easy performance,safety and efficacy.