喉罩与面罩在无抽搐电休克中的应用比较

Application comparisons between laryngeal mask and face mask in modified electroconvulsive therapy

目的 观察喉罩与面罩对无抽搐电休克治疗患者的呼吸功能及血流动力学的影响.方法 将60例需行无抽搐电休克治疗的患者随机分为喉罩组和面罩组,在麻醉前(T0)、麻醉后(T1)、应用喉罩/面罩前(T2)、应用喉罩/面罩后(T3)、通电即刻(T4)、通电后(T5)、去除喉罩/面罩后(T6)记录血氧饱和度(SpO2)、心率(HR)、收缩压(SBP)、舒张压(DBP)四项指标,并计算心率与收缩压的乘积估计心肌的耗氧(HR×SBP).结果 两组比较,SpO2差异无统计学意义(P＞0.05),HR、SBP、DBP、SBP×HR在T3时喉罩组显著高于面罩组(P＜0.05),T0、T1、T2、T4、T5、T6时差异无统计学意义(P＞0.05).结论 两种通气方法都可以安全用于无抽搐电休克治疗,面罩更易操作且血流动力学稳定,喉罩应用在稍长时间的控制通气麻醉更合适.

Objective To observe the effects of laryngeal mask and face mask on respiratary function and hemodynamics of patients under going modified electroconvulsive therapy(MECT).Methods Sixty patients undergoing MECT were randomly divided into laryngeal mask and face mask group,SpO2, HR, SBP and DBP were recorded and cross product of HR and SBP was computed to estimate myocardial oxygen consumption(HR × SBP)at preanesthesia(T0), postanesthesia(T1), pre - laryngeal mask/face mask(T2)usage, post - laryngeal mask/face mask(T3)usage, electrifing at once(T4), post -electrifing(T5)and removing of laryngeal mask/face mask(T6).Results There was no significant difference in SpO2 between the two groups(P ＞ 0.05); HR, SBP, DBP and HR × SBP were significantly higher in the laryngeal group than that in the face mask group at T3(P ＜ 0.05), but there were no significant differences at T0, T1, T2, T4, T5 and T6(P ＞ 0.05).Conclusions Both ventilation approaches can be used in MECT securely,face mask is operated more easily and have more stable hemodynamics,but laryngeal mask is more suitable for anesthesia needing slightly long- playing controlled ventilation.