喉罩通气全麻在老年患者膀胱肿瘤电切术中的应用

目的:探讨喉罩通气全麻用于膀胱肿瘤电切术对老年患者血流动力学及闭孔神经反射的影响。方法:选择行膀胱肿瘤电切术老年患者60例,ASAII级或III级,随机分为两组,A组:腰麻组,30例;B组:喉罩全麻组,30例。分别于麻醉前、麻醉后、术中、术后记录收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),记录术中发生闭孔神经反射情况。结果:B组SBP、DBP和HR波动比A组小,差异有统计学意义(P<0.05)。B组无闭孔神经反射发生,明显好于A组26.7%的发生率。结论:在膀胱肿瘤电切术的麻醉中,喉罩通气全麻对老年患者血流动力学干扰小,术中闭孔神经反射发生率低,是膀胱肿瘤电切术较适宜的麻醉方法。

Objective：To investigate the influence of total intravenous anesthesia with laryngeal mask airway on hemodynamics and obturator nerve reflex in old patients undergoing transurethral resection of bladder tumor.Methods：Sixty ASA II or III old patients undergoing transurethral resection of bladder tumor were randomly di-vided into two groups.Group A：laryngeal mask airway,n = 30;group B：spinal anesthesia,n = 30.SBP,DBP,MAP,HR and pertinent side-effects were monitored and recorded.Results：The homodynamic in group B experienced more stable than those in group A.Obturator nerve reflex was observed in 8 patients in group A,but none in group B.Conclusion：Total intravenous anesthesia with laryngeal mask airway has small interference on homodynamic in old patients undergoing transurethral resection of bladder tumor,and eliminate obturator nerve reflex.