双管喉罩在脊柱后路手术中的安全性和有效性

Safety and effectiveness of ProSeal laryngeal mask airway in posterior spinal surgery

目的 探讨双管喉罩在脊柱后路手术中应用的临床效果及安全性.方法 40例ASA分级Ⅰ～Ⅱ级择期行胸腰椎骨折手术患者按照机械抽样法随机分为双管喉罩组和气管插管组,每组20例.两组患者常规麻醉诱导后,分别置入双管喉罩或气管插管.观察记录操作次数、时间;记录诱导前（T0）,置入即刻（T1）,置入后1 min（T2）、3 min（T3）、5 min（T4）、10 min（T5）及拔除即刻（T6）的收缩压、舒张压、心率;记录置入、拔除及维持通气过程中的并发症.结果 两组置人双管喉罩和气管插管均一次成功,所需时间比较差异无统计学意义（P＞0.05）.气管插管组T1、T2、T3、T6时收缩压、舒张压、心率显著高于T0（P＜0.05）,且也显著高于双管喉罩组（P＜0.05）.气管插管组置人、拔除、维持通气过程中发生并发症者（5、25、36例次）明显多于双管喉罩组（0、1、6例次）（P＜0.05）.结论 双管喉罩用于脊柱后路手术是安全和有效的.

Objective To explore the effect iveness and safety of ProSeal laryngeal mask（PLMA）used in posterior spinal surgery. Methods Forty ASA Ⅰ - Ⅱ patients of thoracic-lumbar fracture were randomly divided into PLMA group and tracheal intubation （TI） group by systematic sampling with 20 cases each. PLMA or TI was inserted after intravenous anesthesia induction. The number of intubation, intubation time and time to surgery were recorded, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and heart rate （HR） were recorded induction （To）, during intubation （T1）, at 1 min （T2）,3 min（T3）, 5 min （T4）, 10 min after intubation （T5）, during extubation （T6）. The intubation, extubation, and the maintain ventilation process of the respiratory and respiratory damage were recorded. Results All patients in PLMA group and TI group achieved satisfactory lung ventilation at the first attempt. There were no significant difference in the number of intubation, intubation time and time to surgery between two groups （P 〉 0.05 ）.SBP,DBP,HR at T1,T2,T3,T6 in TI group were significandy higher than To and those in PLMA group （P〈0.05）. The intubation, extubation, and the maintain ventilation process of the respiratory and respiratory damage in TI group （5,25,36 cases） were more than those in PLMA group （0,1,6 cases）（P 〈0.05）.Conclusion PLMA for posterior spinal surgery is safe and effective.