SLIPA喉罩在烧伤整形手术麻醉中的应用

目的：评估SLIPA喉罩在烧伤整形手术麻醉中的应用效果,并探讨其安全性和有效性。方法：ASAⅠ-Ⅱ级择期瘢痕切除植皮术患者80例,随机均分为SLIPA喉罩组（L组）和气管插管组（T组）,分别记录两组患者在麻醉诱导前、诱导后,插管（喉罩）时、手术开始后10mi n及术毕拔管（喉罩）时的心率（HR）,血氧饱和度（SPO2）,收缩压（SBP）,舒张压（DBP）的变化,记录人工气道建立成功时、成功后30im n及手术结束时的平均气道压（Pmean）、气道峰压（Ppeak）、呼气末二氧化碳分压（PetCO2）和术后咽喉疼痛的病例数。结果：两组均能顺利完成手术,喉罩组和气管插管组在人工气道建立成功时、成功后30im n及手术结束时Pmean、Ppeak、Pet CO2比较,差异均无统计学意义;L组的血流动力学变化明显少于T组,两组比较有显著性差异,术后咽喉痛痛的例数也少于T组。结论：全麻SLIPA喉罩通气用于烧伤整形手术患者优于气管插管,易于维持血流动力学稳定,应激反应轻微,全麻后恢复平稳。

Application of SLIPA laryngeal mask for burn and plastic operation

Objective To evaluate the application effects of general anesthesia with SLIPA laryngeal mask for burn and plastic operation.Methods 80 patients with operation of ASA Ⅰ-Ⅱ grade selective scar excision and skin grafting,80 patients were randomly divided into two groups： SLIPA laryngeal mask airway group（group L） and endotracheal intubation group（group T）.The variation of heart rate（HR）,oxygen saturation（SPO2）,systolic blood pressure（SBP）and diastolic blood pressure（DBP） were recorded respectively before anesthesia induction,after anesthesia induction,intubation（laryngeal mask） period.Recorded the time of success construction for artificial airway,30 mins after success construction and average airway pressure（Pmean）,airway peak pressure（Ppeak）,Pet CO2 and number of post operation throat pain at operation ending time.Results Two groups operation were all finished successfully,the success artificial airway construction of group L and group T during operation,after 30 mins operation and operation ending time,the Pmean,Ppeak and PetCO2 were compared.There was no statistical significant;The hemodynamic changes in group L was less than group T,therefore the two groups had significant difference.The patient number in group L of post-operative throat pain were also less than the group T.Conclusions General anaesthesia with SLIPA laryngeal mask Ventilation on burn and plastic operation was better than endotracheal intubation,also SLIPA laryngeal mask was easy to maintain stable hemodynamics,less cardiovascular stress and shorter recover time after general anaesthesia.