小儿麻醉期间氧化亚氮对双腔喉罩套囊内压的影响

Effect of nitrous oxide on cuff pressure of ProSeal laryngeal mask airway during pediatric anesthesia

目的研究小儿麻醉期间氧化亚氮(N2O)对双腔喉罩套囊内压的影响。方法择期手术小儿32例,麻醉诱导后置入双腔喉罩,随机分成两组,分别向喉罩套囊内预注空气(A组)或50%N2O(N组)使套囊内压至20 mmHg。术中持续吸入50%N2O并监测喉罩套囊内压。结果术中A组喉罩套囊内压逐渐上升至(40.6±9.3)mmHg(P<0.05),而N组套囊内压略有下降。术后拔管空气组套囊内气体量明显增加,而N组则无明显变化(4.4±2.3)mLvs(2.6±1.0)mL,(P<0.05)。术后A组有2例发生咽痛,N组无咽痛发生。结论小儿麻醉期间吸入N2O使双腔喉罩套囊内压明显升高,套囊内预充50%N2O可以防止喉罩套囊内压的升高。

Objective To evaluate the effect of nitrous oxide （ N2O） on the cuff pressure of ProSeal laryngeal mask airway （PLMA） in pediatric anesthesia, Methods Thirty-two pediatic patients were enrolled and divided into two groups randomly. PLMA cuffs were inflated with air （Group A） or 50% N2O/oxyen （Group N） to 20 mmHg as initial pressure. The intracuff pressure was monitored during anesthesia with 50% N2O in oxygen. Results Intracuff pressure increased to （40.6 ± 9.3） mmHg in Group A and slightly decreased in Group N. Deflation volume in Group A was much more than that in Group N[（4.4±2.3） mLvs （2.6±1.0） mL, P〈0.05]. Two patients complained of sore throat in Group N, while nobody did in Group A. Conclusion Inflation of the cuff with air prior to administration of N2O results in high intracuff pressure. In contrast, inflation of the cuff with the gas mixture of 50% N2O/oxyen can maintain stable intracuff pressure.