喉罩通气道在妇科腹腔镜手术中的应用

Application of Laryngeal Mask Airway in Gynecologic Laparoscopic Surgery

目的总结80例择期妇科腹腔镜手术病人应用喉罩通气道(LMA)的临床经验.方法将80例择期腹腔镜下卵巢囊肿切除、异位妊娠病灶清除术的病人,随机分为静脉快诱导(用肌松药,A组)和静脉慢诱导组(不用肌松药,B组),每组40例.在麻醉诱导后经口盲探置入LMA.在喉罩置入前、置入后即刻、置入后3 min、5min观察记录血压、心率变化.观察喉罩的置入情况以及不同诱导方法时的置入条件.结果①LMA操作简单、置入容易;②置入时对循环系统无明显影响;③静脉快诱导(使用肌松药)和慢诱导(不用肌松药)均可获得良好的置入条件;④解决置入时咽后壁受阻的最有效方法是借助于直接喉镜.结论喉罩通气全麻可以安全、有效地应用于妇科腹腔镜手术.

Objective To summarize the clinical experience of 60 patients at fixed period using laryngeal mask airway（LMA）.Mainly observe on the placement,cyclic response and induction Method with different conditions of laryngeal mask.Methods： 80 patients laparoscopic resection of ovarian cyst electie colorectal lesions,ectopic pregnancy,randomized fast induced by intravenous（muscle relaxants,A group） and slow induction（without muscle relaxants group B）,40 cases in each group.In the mouth after narcotic induction agents LMA into blind.In the former,laryngeal mask immediately after put into 3min 5min,after placement,blood pressure and heart rate changes observation records.Result ①LMA is easy to place,simple to operation and damage less.②Placement influences nothing obvious on circulation.③ Intravenous fast induction（use muscle relaxants） and slow induction（without muscle relaxants） can all get good placement conditions.④The most effective method to solve the swallow placement is direct laryngoscopes.Conclusion special applications of laryngeal mask airway in gynecology laparoscopic surgery and anesthesia is better than the endotracheal tube.With strict control in laryngeal mask airway indications and contraindications,preoperative strictly fast and strengthen water under the premise of anesthesia management,it can be safely and effectively applied to laparoscopic surgery,but in clinical it also should be noticed that the danger of using of LMA in airway obstruction occurs at any time.