气管插管与i-gel喉罩在腹腔镜手术麻醉中的应用比较

目的探讨i-gel喉罩与气管插管在腹腔镜手术中患者的心血管反应以及术后并发症的发生情况。方法选择常规腹腔镜手术50例,ASA分级Ⅰ-Ⅱ级,年龄在20-66岁,随机分两组：i-gel喉罩组（A组）及气管插管组（B组）。分别于麻醉诱导前（T1）、插管（罩）即刻（T2）、气腹即刻（T3）、气腹后10 min（T4）、停止气腹（T5）、拔管（罩）即刻（T6）等6个时间点观察两组的HR、MAP、PETCO2等指标。结果 B组插管、拔管过程中,患者HR,MAP等心血管反应较A组有明显升高（P〈0.05）PET CO2无明显变化。术后吸痰例数,咽喉痛,B组较A组有显著增多（P〈0.05）。手术结束至苏醒拔管时间B组较A组有明显的延长（P〈0.05）。结论在全麻腹腔镜手术中使用i-gel喉罩,患者的心血管反应变化小,血流动力学平稳,术后不良反应少,安全性高,值得临床推广。

Comparison of the clinical efficacy of endotracheal intubation and I-gel laryngeal mask during the laparoscopic surgery

Objective To evaluate the cardiovascular response and postoperative complications during the laparoscopic surgery with the use of I-gel laryngeal mask（ LMA） and tracheal intubation respectively. Methods Fifty cases of conventional laparoscopic surgery with ASA graded Ⅰ - Ⅱgrade and aged 20 - 66 years were randomized into two groups：I-gel LMA group（Group A） and endotracheal intubation group（Group B）. The values of HR,MAP and PETCO2of the 2 groups at 6 time spots were recorded. Results The cardiovascular responses of group B during intubation and extubation were significantly pronounced compared with those in group A,with no difference in PETCO2between the two groups. The incidence of sore throat,hoarseness postoperative suction was significantly increased in group B than that in group A. The wake time from the end of surgery of group B was significantly longer than group A. Conclusions The use of the I-gel LMA during conventional laparoscopic surgery has the advantages of less cardiovascular responses and fewer adverse reactions compared with the endotracheal intubation.