喉罩与腰-硬联合麻醉在侧卧位下肢手术的应用

Laryngeal mask and combined spinal-epidural anesthesia applied in patient undergoing lower extremity's operation at lateral position

目的观察喉罩插管全身麻醉和腰-硬联合麻醉在侧卧位下肢手术的应用。方法 60例患者均分为两组:喉罩组(A组)采用喉罩插管全身麻醉,腰-硬联合麻醉组(B组)采用腰-硬联合麻醉。A组患者在摆好侧卧位后行喉罩插管,全程自主呼吸;B组患者行腰-硬联合麻醉,平卧位待麻醉平面出现后再摆侧卧位,全程自主呼吸。观察两组患者麻醉开始至手术开始时间,一次性操作成功率、术中低血压、术中不适发生率、麻醉相关并发症发生率及苏醒时间。结果 A组麻醉开始至手术开始时间明显短于B组(P<0.05),术中低血压及不适发生率、一次性操作成功率低于B组(P<0.05)。结论喉罩插管全身麻醉方便、有效,在侧卧位下肢手术中,是值得推荐的全麻方式。

Objective To observe the application of laryngeal mask and combined spinal- epidural anesthesia in the lower extremity＇s operation. Methods Sixty cases were randomly divided into laryngeal mask group （group A） and combined spinal-epidural group （group B）. Group A was administrated anesthesia with laryngeal-mask after the patients in lateral position, all patients breathed spontaneously during operative period. Group B was administrated combined spinal-epidural anesthesia before the patients in lateral postion. The following index were observed, the duration from anesthesia onset to surgical incision, the incidence of first time operating success, the incidence of low blood pressure and discomfort during operation, complications related to anesthesia and the time of palinesthesia. Results The duration from anesthesia onset to surgical incision shortened in group A （P 〈~ 0.05）, the incidence of low blood pressure, discomfort during operation and complication of anesthesia were low in group A, but the incidence of first time operating success was low in group A （P^0.05）. Conclusion Laryngeal mask airway is a safe and effective method in general anesthesia, especially in the patient undergoin~ lower extremitv＇s operation al lateral Dosition