改良Proseal喉罩与改良普通喉罩在无痛纤维支气管镜检查中的气道管理

目的比较改良Proseal喉罩和改良普通喉罩在无痛纤维支气管镜检查中气道管理的效果。方法选择行纤维支气管镜检查患者40例,随机均分为两组:改良Proseal喉罩组(P组)和改良普通喉罩组(L组)。全麻诱导后徒手插入喉罩,接麻醉机,控制或辅助通气。记录两组麻醉前(T0)、插入喉罩即刻(T1)、插入喉罩3min(T2)的SBP、DBP、HR和SpO2,同时记录喉罩插入时间和并发症,并进行喉罩通气评估、纤维支气管镜评估和气道密封压测定。结果两组患者喉罩插入时间及各时点的SBP、DBP、HR和SpO2差异均无统计学意义;P组气道密封压明显高于L组(P<0.01);P组喉罩通气、纤维支气管镜评分优良率均为100%,明显高于L组的85%、80%(P<0.01);术毕P组1例喉罩粘血,明显少于L组的7例(P<0.05)。结论改良Proseal喉罩在气密性、通气评估、纤维支气管镜评估等方面好于改良普通喉罩,但对血流动力学的影响两者无明显差异。

Comparison of modified Proseal laryngeal mask and three-way laryngeal mask airway for painless fiberoptic bronchoscopy in airway management in effect

Objective To compare the effects of airway management with modified Proseal laryngeal mask airway and modified laryngeal mask airway in painless fiberoptic bronchoscopy.Methods Forty patients who scheduled for painless fiberoptic bronechscopy were randomly divided into two groups (n=20): Modified Proseal laryngeal mask airway group (group P) and modified laryngeal mask airway group (group L). After induction of general anesthesia were inserted with hands. BP, HR and SpO2 were measured respectively before anesthesia laryngeal mask airway (T0), immediately after inserting laryngeal mask airway (T1) and 3 min (T2). The laryngeal mask airway insertion time, complications, the ventilated assessment, fiberoptic bronchoscopy assessed and airway sealing pressure were also simultaneously recorded.Results There was no significant difference in laryngeal mask airway insertion time, BP, HR and SpO2 at each point. Airway sealing pressure in group P was significantly higher than that in group L (P<0.01). The excellent rates of ventilated assessment and fiberoptic bronchoscopy scores were both 100% in group P, and were much higher than those in group L (85%, 80% respectively P<0.01).Blood staining in group P was less than that in group L (1 vs. 7 cases, respectively P<0.05).Conclusion The modified Proseal laryngeal mask is better than modified laryngeal mask airway at the aspects of gas-tightness, assessment of ventilafion and fiberoptic bronchoscopy, but no effects on hemodynamics in two groups.