小儿疝气手术运用喉罩麻醉与气管插管麻醉的效果分析

Analysis of the effect of laryngeal mask anesthesia and tracheal intubation anesthesia in pediatric hernia surgery

目的探讨小儿疝气手术中应用喉罩麻醉、气管插管麻醉的效果。方法64例疝气手术患儿,采用抽签法分为参照组和试验组,每组32例。参照组采用气管插管麻醉,试验组采用喉罩麻醉。比较两组不同时间点[入室时、插管(戴喉罩)时、插管(戴喉罩)5 min、气腹建立时、放气腹时、拔管(摘喉罩)时]血流动力学指标(收缩压、心率、平均动脉压、血氧饱和度),麻醉恢复相关指标[复苏时间、拔管(摘喉罩)时间、瑞芬太尼用量],并发症发生情况。结果入室时,两组患儿的收缩压、心率、平均动脉压、血氧饱和度水平比较差异均无统计学意义(P>0.05)。插管(戴喉罩)时、插管(戴喉罩)5min、气腹建立时、放气腹时、拔管(摘喉罩)时,试验组患儿的收缩压、心率、平均动脉压均低于参照组,血氧饱和度高于参照组,差异具有统计学意义(P<0.05)。试验组复苏时间(15.01±2.11)min、拔管(摘喉罩)时间(7.61±2.22)min均早于参照组的(19.73±3.26)、(14.88±3.03)min,瑞芬太尼用量(107.97±11.34)μg少于参照组的(196.45±12.53)μg,差异具有统计学意义(P<0.05)。试验组并发症发生率3.13%低于参照组的18.75%,差异具有统计学意义(P<0.05)。结论小儿疝气手术中,无论是喉罩麻醉,还是气管插管麻醉,均具有理想效果。相较于气管插管麻醉,喉罩麻醉对血流动力学指标影响更小,并且还可降低并发症发生率,有利于减少麻醉药物用量,在加快患儿苏醒方面作用更为突出。

Objective To discuss the effect of laryngeal mask anesthesia and tracheal intubation anesthesia in pediatric hernia surgery.Methods A total of 64 children with hernia surgery were divided into a reference group and an experimental group using the lottery method,with 32 cases in each group.The reference group received tracheal intubation anesthesia,and the experimental group received laryngeal mask anesthesia.Both groups were compared in terms of hemodynamic indices(systolic blood pressure,heart rate,mean arterial pressure,oxygen saturation)at different time points[when entering the operative room,at tracheal intubation(laryngeal mask airway insertion),at tracheal intubation(laryngeal mask airway insertion)for 5 min,at pneumoperitoneum establishment,at pneumoperitoneum release,at tracheal extubation(removal of laryngeal mask airway),anesthesia recovery-related indices(resuscitation time,extubation[removing laryngeal mask)time,remifentanil dosage],and occurrence of complications.Results When entering the operative room,the differences in systolic blood pressure,heart rate,mean arterial pressure,and oxygen saturation levels between the two groups were not statistically significant(P>0.05).At tracheal intubation(laryngeal mask airway insertion),at tracheal intubation(laryngeal mask airway insertion)for 5 min,at pneumoperitoneum establishment,at pneumoperitoneum release,at tracheal extubation(removal of laryngeal mask airway),the systolic blood pressure,heart rate,mean arterial pressure of children in the experimental group were lower than those in the reference group,and the oxygen saturation was higher than that in the reference group,and the differences were statistically significant(P<0.05).The resuscitation time(15.01±2.11)min and tracheal extubation(removal of laryngeal mask airway)time(7.61±2.22)min in the experimental group were earlier than(19.73±3.26)and(14.88±3.03)min in the reference group,and the remifentanil dosage(107.97±11.34)μg was less than(196.45±12.53)μg in the reference group;and the differences were statistically significant(P<0.05).The incidence of complications of the experimental group was 3.13%,which was lower than 18.75%of the reference group,and the difference was statistically significant(P<0.05).Conclusion In pediatric hernia surgery,both laryngeal mask anesthesia and tracheal intubation anesthesia have ideal effects.Compared with tracheal intubation anesthesia,laryngeal mask anesthesia has less impact on hemodynamic indicators,and can also reduce the incidence of complications,which is conducive to reducing remifentanil dosage,and has a more prominent role in accelerating the recovery time of children.