喉罩麻醉与气管内插管麻醉的临床分析

Clinical analysis of laryngeal mask airway anesthesia and endotracheal intubafion anesthesia

目的观察喉罩麻醉与气管内插管麻醉用于乳腺癌手术的安全性和可行性。方法40例行择期乳腺癌根治术患者，ASA分级均为Ⅰ～Ⅱ级，随机分为喉罩组（A组）和气管导管组（B组），每组20例。观察和记录两组患者麻醉前（T0）、插管或放置喉罩后即刻（T1）、插管或放置喉罩后5min（T2）、术后拔管或喉罩后即刻（T3）、拔出导管或喉罩后5min（L）的SBP、DBP、HR和SpO2。观察和随访两组患者拔管期不良反应和术后麻醉相关并发症。结果B组T1、L的SBP、DBP、HR显著高于A组（P〈0．05）；B组拔管期躁动、呛咳和术后咽痛明显高于A组（P〈0.05）。结论与气管插管全麻相比，喉罩通气全麻用于乳腺癌根治术血流动力学更平稳，麻醉相关并发症更少。

Objective To study the safety and efficacy of laryngeal mask airway（LMA） used in breast cancer general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients with breast cancer scheduled for selective radical mastectomy under general anesthesia were allocated randomly to either laryngeal mask airway group（ group A,n =20） or tracheal tube group （ group B, n = 20）. SBP, DBP, HR, SpO2 of patients before anesthesia （ To ）/after intubation imme- diately （ Tt ） and 5 minutes （ T2 ） after intubation tracheal tube or laryngeal mask intubation/after extubation immediately （T3 ） and 5 minutes（ T4 ） of after extubation tracheal tube or laryngeal mask were recorded. The different incidence of anesthetic complications and side effect were observed in both groups because intubation and extubation. Results In group B, SBP, DBP and HR were significantly higher than those in group A at T1 and T3 （ P 〈 0.05 ）. Agitation, bucking and pharyngodynia incidence rate in group B were significantly higher than group A（P 〈 0.05 ）. Conclusion Ventilation with LMA in patients underwent breast cancer radical correction was better than endotracheal intubation general anesthesia in keeping stable hemodynamics and producing less anesthetic complications.