喉罩在神经介入手术中的应用效果观察

目的观察喉罩（laryngeal mask airway,LMA）在全麻下神经介入手术中对呼吸循环功能的影响。方法选择40例择期行神经介入手术患者,ASAⅡ~Ⅲ级,采用随机数字表法分为喉罩组（L组）和气管插管组（T组）各20例,两组均采用丙泊酚复合瑞芬太尼静脉麻醉。比较两组置罩（管）和拔罩（管）前后心率（HR）、平均动脉压（MAP）的变化情况,并记录两组麻醉药用量以及拔管（罩）期各种并发症的情况。结果 L组置罩后和拔罩前后HR、MAP无明显变化（P〉0.05）;T组插管后及拔管前后的HR、MAP均较插管前明显升高（P〈0.05）;L组麻醉药用量少,停药后苏醒快,并发症明显少于T组。结论 LMA用于全麻下神经介入手术通气效果好、安全可靠,且有血流动力学平稳、苏醒快、并发症少等优点。

Clinical observation on laryngeal mask airway in neural intervention operation

Objective To observe the influence of laryngeal mask airway（LMA）on circulation and respiratory function in neural intervention operation under general anesthesia.Methods Forty ASAⅡ~Ⅲ patients scheduled for elective neural intervention operation with Propofol and Remifentanil total intravenous anesthesia were randomly divided into two groups：the tracheal intubation group（group T,20 cases）and the LMA group（group L,20 cases）.Heart rate（HR）and mean arterial pressure（MAP）were measured before and after intubation and extubation of LMA/tracheal intubation.Anesthetic dosage and postoperative complications were recorded.Results In group T,the values of HR and MAP after intubation and before and after extubation increased significantly compared with those before intubation（P0.05）.In group L,no significant changes occurred after intubation and before and after extubation（P0.05）.Group L,with less anesthetic dosage and rapid recovery time,has significantly less complications than those in group T.Conclusion LMA can provide safe and effective ventilation for neural intervention operation under general anesthesia,which has many advantages including stable hemodynamics,rapid recovery time and few complications.