在妇科腹腔镜手术中应用Proseal喉罩全麻的疗效观察

目的观察ProSeal喉罩全麻在妇科腹腔镜手术中应用的有效性和安全性。方法选择妇科腹腔镜手术患者50例,ASAⅠ~Ⅱ级,随机分为ProSeal喉罩组(P组n=25)和气管插管组(T组n=25),麻醉诱导插管后,观察心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SPO2)、呼气末二氧化碳分压(PETCO2)、气道峰压(Ppeak)、气道平均压(Pmean),并记录两组拔管期的不良反应及术后并发症等。结果 P组在喉罩置入和拔出前后的时间点HR、MAP无明显变化(P>0.05),T组插管后即刻和拔管后即刻HR、MAP均显著升高(P<0.05)。两组PETCO2、Ppeak、Pmean随气腹的影响变化一致,组间比较差异无统计学意义(P>0.05)。拔管期间P组发生的体动、呛咳较T组明显减少,差异有统计学意义(P<0.05),套囊血迹及术后咽喉痛、声嘶两组比较差异无统计学意义(P>0.05)。结论本研究显示,在全麻妇科腹腔镜手术中ProSeal喉罩可达到与气管插管一样满意的通气效果,且心血管应激反应小,体动、呛咳发生率减少。

The Research of Proseal Laryngeal Mask Airway Used in Gynaecological Laparoscopy Operation under General Anesthesia

Objective To observe the safety and efficacy when Proseal laryngeal mask（LAM） used in gynaecological laparoscopy operation under positive pressure ventilation.Methods Fifty ASA Ⅰ-Ⅱ patients undergoing elective general anesthetic operation were randomly allocated to either Proseal laryngeal mask airway group（P,n=25） or tracheal tube group（T,n=25）.After anesthesia induction and tracheal tube or laryngeal mask intubation,Monitoring parameters included HR,interval noninvasive MBP,SPO2,PETCO2,Ppeak,Pmean.Extubation response and postoperational complications were recorded.Results HR and MBP in Group T were signi？cantly increased after intubation and extubation （P〈0.05）,which were not in group P（P〉0.05）.SPO2,PETCO2,Ppeak,Pmean,were similar at all the time points between the two groups（P〉0.05）.Group T had higher incidence of body movement and coughing before extubation （P〈0.05）.The incidence of blood cuff,sore throat and hoarse postoperatively was not significant difference between the two groups（P〉0.05）.Conclusions LAM- Proseal intubation can provide the same safe and effective ventilation as tracheal intubation in gynaecological laparoscopy operation under positive pressure ventilation.LAM- Proseal is superior to tracheal intubation in intubation and extubation response,the incidence of body movement and coughing.