LMA Supreme喉罩全麻在腹腔镜胆囊手术中的可行性

The feasibility of aaryngeal mask airway supreme in general anesthesia undergoing laparoscopic cholecystectomy

目的探讨LMA Supreme一次性双管喉罩在腹腔镜胆囊手术中的应用效果。方法 80例ASA为～Ⅱ级择期全麻腹腔镜胆囊手术患者,随机分为Ⅰ组(喉罩组,n=40)和Ⅱ组(气管导管组n=40)。对比分析两组术中血流动力学变化、记录麻醉诱导前(T0)、诱导后(T1)、插管(罩)后即刻(T2)、插管(罩)后3min(T3)、拔管(罩)后即刻(T4)、拔管(罩)后3min(T5)等时点的HR、SBP、DBP、SpO2的变化、麻醉合并症及不良反应。结果两组T1及Ⅰ组T2时SBP、DBP降低(P<0.05),Ⅰ组在T2、T3、T4和T5等各时点HR,SBP、DBP比较差异无统计学意义(P>0.05);Ⅱ组在T2、T3、T4和T5等各时点HR、SBP、DBP比T0及Ⅰ组明显升高(P<0.05)。Ⅰ组在T4和T5时患者呛咳、体动以及术后咽喉痛的发生明显少于Ⅱ组(P<0.05)。两组其他合并症及不良反应发生率比较差异无统计学意义(P>0.05)。结论 LMA Supreme喉罩全身麻醉血流动力学平稳,与气管插管比较可明显降低心血管反应,并发症少且操作容易,可安全有效地用于腹腔镜胆囊切除术。

Objective To explore the clinical effects of laryngeal mask airway supreme（LMA Supreme） and endotracheal intubation used for laparoscopic cholecystectomy（LC）.Methods 80 cases ASA grade I-II patients undergoing elective LC under general anesthesia were randomly allocated to two groups with 40 cases each.GroupⅠ（n = 40） received LMA Supreme and group Ⅱ（n = 40） received endotracheal tube（ETT）.The hemodynamic changes of two groups were compared and analyzed during anesthesia.HR,SBP,DBP,SpO2 were recorded before anesthesia（T0）,after induction（T1）,at the time of LMA Supreme/ETT（T2）,3 min after LMA Supreme/ETT（T3）,at the time of extubation（T4） and 3 min after extubation（T5）,the complications and adverse reactions of anesthesia were recorded during each operation.Results SBP and DBP were found significantly lower than baseline at the time of T1 in both groups and at the time of T2 in group I（P0.05）,HR,SBP and DBP were not significantly different at each point of T2、T3、T4 and T5 in group I（P0.05）;HR,SBP,DBP were significantly higher than T0 and group I at each point of T2、T3、T4and T5 in groupⅡ（P0.05）.The patients choke and body movement in group I were found significantly lower than those in groupⅡ（P0.05）,the occurrence of postoperative sore throat was obviously lower than that in groupⅡ（P0.05）.The incidence of complication and adverse reactions in both groups was not significant（P0.05）.Conclusion General anesthesia of LMA Supreme has a stability on the hemodynamic change and can reduce the adverse cardiovascular effects,insertion easy with fewer complications,making it can be safely and effectively used for laparoscopic cholecystectomy.