BIS值40-60喉罩对全麻患者血流动力学的影响

目的:比较BIS值40-60喉罩和气管插管对全麻患者血流动力学的影响。方法:选择ASAⅠ-Ⅱ级,择期全麻手术患者89例,随机分成两组:A组(喉罩组)43例,B组(气管插管组)46例,两组患者均常规行全凭静脉麻醉诱导和维持,术中将BIS维持在40-60水平。记录各组患者麻醉前(To),诱导后(T1),喉罩或气管导管插入后3min(T2),手术开始后30min(T3),术毕(T4),拔除喉罩或气管导管前(T5)和拔除后3min(T6)的血压、心率、脉搏氧饱和度及脑电双频谱指数(BIS),同时记录各组患者的苏醒时间、苏醒质量、患者满意度及气道并发症。结果:T1时点两组患者血压、心率、BIS均低于T0时点,差异有统计学意义;T2时点B组血压、心率均恢复到麻醉前水平,与A组比较差异有统计学意义;T3时点A组血压、心率高于B组,差异有统计学意义;T4时点A组血压、心率及BIS均高于B组,差异有统计学意义;T5、T6时点B组血压、心率均高于A组,而BIS低于A组,差异有统计学意义。B组苏醒时间长于A组,而苏醒质量低于A组,差异有统计学意义。A组患者满意度优于B组,A组气道并发症少于B组,差异有统计学意义。结论:喉罩通气对全麻患者的血流动力学影响相对气管插管较小,且具苏醒质量高,气道并发症少等优点。

Influence of laryngeal mask and tracheal intubation between BIS40-60 on hemodynamics of patients undergoing general anesthesia

Objective: To compare the influence of laryngeal mask and tracheal intubation on hemodynamics of patients undergoing general anesthesia.Methods: A total of 89 cases categorized as ASAⅠ-Ⅱ that were scheduled for surgery under general anesthesia were divided into group A(laryngeal mask group,43 cases) and group B(tracheal intubation group,46 cases).Both groups were given routine intravenous anesthesia,and BIS were maintained between 40-60.blood pressure,heart rate,oxygen saturation and bispectral index(BIS) of each patient in two groups were recorded at following time points: before anesthesia(T0),after induction(T1),3 min after laryngeal mask or endotracheal tube insertion(T2),30 min after the start of the surgery(T3),after surgery was finished(T4),before removing laryngeal mask or endotracheal tube(T5) and 3min after removing artificial airway(T6).Recovery time and recovery quality,as well as incidence of airway complications of each patient in two groups were also recorded.Results:At T1 blood pressure,heart rate,BIS in two groups were fewer than that at T0 showing statistical significance;at T2,blood pressure and heart rate in group B were restored to the level before the anesthesia,and there was a statistical significance comparing with that in group A;blood pressure and heart rate in group A were higher than that of group B at T3 and T4;BIS in group A was higher than that in group B at T5 and T6,but blood pressure and heart rate were higher in group B than that of group A.Recovery time of group B was longer than that of group A,but recovery quality was poorer in group B than that in group A,the degree of satisfaction of group A was higher than that in group B,airway complications in group A was less than that in group B,there was a statistical significance.Conclusions: The influence of laryngeal mask on hemodynamics is less than that of tracheal intubation in general anesthesia,also laryngeal mask airway has higher recovery quality and less airway complications than tracheal intubation.