SLIPA喉罩与气管插管在全麻输尿管镜钬激光碎石术中的比较

目的探讨SLIPA喉罩与气管插管在全麻输尿管镜钬激光碎石术中应用效果的比较，为短小手术提供新的麻醉管理方案。方法选择ASAⅠ～Ⅱ级、择期全麻下输尿管镜钬激光碎石术患者72例，随机分成SLIPA喉罩组（S组）和气管插管组（T组），两组麻醉诱导药物相同，维持采用瑞芬太尼加丙泊酚全凭静脉麻醉。记录两组置入喉罩和插管次数、成功率，比较各时点血流动力学的指标，统计两组术中及术后不良反应。结果两组置入的成功率无明显差异（P〉0．05）。SLIPA喉罩组置入和拔出喉罩时的血流动力学平稳，而气管插管组在插管前后、拔管前后MAP、HR明显高于喉罩组。术中S组漏气率27．78％较T组明显增高（P〈0．05）但不影响通气。术后声嘶、咽痛发生率低于T组。结论SLIPA喉罩易于维持血流动力学稳定，术后不良反应少，适用于输尿管镜钬激光碎石术。

Comparing SLIPA laryngeal mask with endotracheal intubation in the holmium laser lithotripsy

Objective Objective discuss the comparison of SLIPA laryngeal mask with endotracheal intubation in the holmium laser lithotripsy, in order to provide a new anesthetic management for short operations. Methods Selected ASA with level Ⅰ - Ⅱ ,under general anesthesia for the 72 patients who would be cured with the holmium laser lithotripsy under ureteroscopy,they would be divided into SLIPA IrMA group（Group S）and tracheal intubation group（Group T）randomly. Induction of anesthesia in the two groups were the same, which maintained with remifentanil and propofol total intravenous anesthesia. Thenumber of the insertion and the intubation, success rates in the two groups were recoeded. Compared with the hemodynamic indicators at each time point,adverse effects of the two groups during and after surgery were recorded. Results The success rates of the two groups had no significant difference in（P〉 0.05）. When SLIPA LMA group LMA was inserted and removed, the hemodynamic was stable. However,MAP, HR of group endotracheal intubation was significantly higher than group IrMA before and after intubation tracheal intubation and extubation. Leakage rate in the patients of group S（27.78）% was significantly higher than T（P〈0.05）, but it did not affect the ventilation. The rates of postoperative hoarseness and sore throat were lower than group T. Conclusions SLIPA laryngeal mask was easy to maintain hemodynamic stability,less postoperative adverse events,which fits the holmium laser lithotripsy under ureteroscopy.