Proseal喉罩在妇科肿瘤手术麻醉中的应用

Application of Proseal laryngeal mask airway during anesthesia of gynecologic oncologic surgery

目的探讨Proseal喉罩（PLMA）应用于妇科肿瘤手术麻醉的安全性及可行性，并与传统气管插管（ETT）比较。方法60例择期行妇科肿瘤手术患者，分为PLMA组及ETT组。记录2组置入时间，试插次数，术中气道峰压，血压、心率，以及麻醉并发症。结果PLMA组置入时间长于ETT组[（48．6±9．3）S比（22.4±5．9）S，P〈0．01]。2组一次置入成功率、术中气道峰压无明显差异（P〉0．05）。PLMA组置罩后血压、心率无明显变化，而ETT组置管后血压、心率明显增高（P〈0．05）。PLMA组苏醒期患者呛咳、体动及术后3h咽喉痛的发生率[6．7％（2／30），10．0％（3／30）]明显少于ETT组[46．7％（14／30），33．3％（10／30）]（P〈0．05）。结论PLMA可安全有效应用于妇科肿瘤手术麻醉。

Objective To investigate the safety and feasibility of Proseal laryngeal mask airway （PLMA） in the anesthesia of gynecologic oncologic surgery, and to compare with traditional endotracheal intubation（ETT）. Methods Sixty patients undergone selective gynecologic oncologic surgery were randomly allocated to PLMA group and ETT group. The insertion time, number of attempts, intraoperative peak airway pressure, blood pressure （BP）, heart rate （HR） and anesthesia complications were recorded. Results The insertion time of PLMA group was longer than that of ETT group [ （48.6±9.3） s vs （22.4±5.9） s, P〈0.01 ]. No statistical difference was found between the two groups in the first time insertion success rate and intraoperative peak airway pressure （P〉0.05）. In PLMA group, BP and HR did not change significantly after inserting the PLMA , while in ETT graup, BP and HR increased significantly after inserting the ETT （P〈 0.05）. The incidence of coughing, bucking, body movement at recovery and postoperative 3 h sore throat of PLMA group [ 6.7 % （2/30）, 10.0% （ 3/30 ） ] was significantly lower than those of ETT group [ 46.7% （ 14/30 ）, 33.3% （10/30） ] （P〈0.05）. Conclusion PLMA can be used safely and effectively in the anesthesia of gynecologic oncologic surgery.