欧普乐喉头罩用于眼科全麻临床分析

Clinical Application of Oro-Pharyngo-Laryngeal Airway Cap under General Anesthesia during Ophthalmologic Surgery

目的：探讨眼科手术自主呼吸全麻中欧普乐喉头罩（OPLAC）的临床应用。方法：选取106例眼科手术患者，随机分为Ⅰ组（OPLAC组，53例）和Ⅱ组（Classic LMA组，53例），静脉麻醉诱导，静吸复合麻醉维持，记录置入时间、置入前后2min的SBP、DBP、HR．SpO2及置入后2min的Paw，术后随访咽干、咽痛、声音嘶哑等症状。结果：Ⅰ组置入时间较Ⅱ组延长（P〈0．001）；置入前后2min比较，Ⅰ组OBP和Ⅱ组SBP．DBP均降低（P〈005），两组HR和SpO2无明显差别（P〉0.05）；置入后2min的Paw和术后咽干发生率组间均相似（P〉0.05）；术后咽痛发生率Ⅰ组显著高于Ⅱ组（P〈0．001）；声音嘶哑Ⅰ组7例，Ⅱ组无。结论：OPLAC通气效果肯定，对血流动力学影响轻微．置入较容易，可用于眼科全麻，但应重视防治术后咽痛、声音嘶哑等并发症。

Objective： To investigate the clinical application of Oro-Pharyngo-Laryngeal Airway Cap （OPLAC） under general anesthesia with spontaneously breathing during ophthalmologic surgery. Methods： 106 adult patients scheduled for selective ophthalmologic surgery under general anesthesia were randomly allocated into two groups： OPLAC group （n=53） and classic-LMA group （n=53）. Anesthesia was induced intravenously, and maintained with intravenous anesthestic and inhalation anesthestic. The timing of insertion and Paw at 2 minute after insertion of the two groups were measured. Changes in SBP, DBP, HR and SpO2 were recorded at 2 minute before and after insertion respectively. And sore throat, dry throat and hoarseness were measured after operation. Results： Insertion time was significantly longer in OPLAC group than that in classic-LMA group （P〈0.001）. DBP of OPLAC group and SBP, DBP of classic- LMA group were all decreased lightly at 2 minute after insertion than that at 2 minute before insertion （P〈0.05）. HR and SpO2 of the two groups were all no significantly changed. Paw at 2 minute after insertion and the incidence of dry throat were significantly similar with the two groups （P〉0.05）. But the incidence of sore throat is significantly higher in OPLAC group than that in classic-LMA group （P〈0.001）. 7 patients had hoarseness in OPLAC group, but no patient in classic-LMA group. Conclusions： Ventilation with OPLAC is surely good. Effects of OPLAC on hemodynamics is not significant. The insertion of OPLAC is easier. OPLAC is available to general anesthesia with spontaneously breathing during ophthalmologic surgery.However, the sore throat and hoarseness happende more in OPLAC Group.