鼻咽通气道在老年腹部手术患者麻醉恢复期的应用

The application of nasopharyngeal airway in elderly abdominal surgery patients during anesthesia recovery

目的观察鼻咽通气道用于老年腹部手术患者,在麻醉恢复期维持上呼吸道通畅的有效性及可行性。方法择期全麻患者120例,年龄65～75岁,ASAⅠ或Ⅱ级,随机分为鼻咽通气道(A组),口咽通气道(B组),手法托颌组(C组),每组40例。术毕拔除气管导管后,随即A组置入鼻咽通气道,B组置入口咽通气道,C组手法托颌,三组均用面罩吸氧(氧流量2L/min)。记录A、B组置入口/鼻通气道时间及一次置管成功率,观察三组拔除气管导管前(T0)、拔管后/置入通气管(C组手法托颌)后5min(T1)、10min(T2)、20min(T3)的SpO2、PaCO2、HR、SBP、DBP,T3后即对三组进行舒适度VAS评分。结果 T2、T3时B、C组PaCO2、SBP明显高于、HR明显快于A组(P<0.05),VAS评分A组明显高于B、C组(P<0.05)。结论鼻咽通气道维持麻醉恢复期老年腹部手术患者的上呼吸道通畅效果较为理想,且患者耐受性佳。

Objective To investigate the effectiveness and feasibility of the nasopharyngeal airway in the elderly abdominal surgery patients during anesthesia recovery period.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients,aged 65-75 years old,undergoing general anesthesia were randomly divided into three groups：nasopharyngeal airway （group A,n=40）,oropharyngeal airway （group B,n=40）,submaxillary-lifting group （group C,n=40）. All the patients were placed with nasopharyngeal,oropharyngeal airway or received submaxillary-lifting after extubation according to the groups. They were also received 2 L/min fresh oxygen through the facial mask. The airway placement time and achievement ratio at the first placement,SpO2,PaCO2,HR,SBP,DBP before extubation,5,10,and 20 min after extubation were investigated. The comfortable score was also recorded. Results PaCO2,HR,SBP in group B and C were higher at T2,T3 than group A （P0.05）. Comfortable VAS score in group A was higher than group B and C （P0.05）. Conclusion Nasopharyngeal airway is a good method to maintain the upper airway in the elderly abdominal surgery patients during anesthesia recovery.