喉罩气道全麻在乳腺癌根治术中的应用

Application of laryngeal mask airway in general anesthesia for radical operations of mastocarcinoma

目的比较喉罩和气管插管应用于全身麻醉的优缺点,为临床麻醉提供参考。方法46例ASAⅠ、Ⅱ级的行“乳腺癌根治术”的患者随机分为喉罩通气道组(L组,23例)和气管插管组(T组,23例),比较两组芬太尼的用量、应激反应、通气与气体交换的情况及麻醉不良反应发生情况。结果两组通气、气体交换良好;T组血流动力学、血糖值改变较为突出,应激反应比L组强烈;T组麻醉不良反应率高于L组。结论喉罩通气道全身麻醉可以很好地应用于乳腺癌根治术。

[Objective] To discover the advantages and disadvantages of the application of laryngeal mask airway （LMA） and tracheal tube （TT） in general anesthesia and to provide clinical reference to anesthetic practice. [Methods] Forty-six ASA physical status Ⅰ～Ⅱ patients underwent modified radical operations of mastocarcinoma under general anesthesia were allocated to 2 groups with 23 cases each. Patients were randomly inserted with LMA （Group L） or TT （Group T） after induction. The hemodynamic changes and the values of blood sugar （BS） were observed perloperatively. The different level of stress response, the different average dosages of Fentanyl used in the anesthesia, the different effects of ventilation and gas exchange, the different incidence of anesthetic complications was observed in both groups. [ Results] All cases in both groups were well ventilated and with excellent gas exchange effect. After induction, one minute after the insertion of TT, at the moment of pulling out the LMA/Tr, the homodynamic changes were obviously great and were especially greater in group T. The values of BS were obviously high one hour after the beginning of operations and after the pulling out the LMA/IT and were especially higher in group T. The stress response level was higher in group T. The incidence of complications was higher in group T. [Conclusion] LMA can be suitably used in general anesthesia for radical operations of mastocarcinoma.