一次性双管喉罩在临床麻醉中的应用

Clinical Application of LMA Supreme in the anesthesia

目的:探讨一次性双管喉罩在临床麻醉中应用适应证及其安全性和可行性。方法:选择全麻下手术病人79例,随机分为一次性双管喉罩(SLMA)组和气管插管组(ET),分别为42例和37例,记录麻醉诱导前、诱导后、置管(喉罩)即刻、置管(喉罩)后3分钟、拔管(喉罩)前及拔管(喉罩)后3分钟SBP、DBP、MBP、HR和SpO2,术中丙泊酚、芬太尼和维库溴胺的用量。结果:两组首次置管成功率分别为97%和95%(P>0.05),术中芬太尼用量无差异(P>0.05),丙泊酚及维库嗅胺用量,ET组明显多于SLMA组(P<0.05);苏醒时间ET组明显长于SLMA组(P<0.05);两组诱导后与诱导前比较,SBP、DBP及MBP差异均有统计学意义(P<0.05);两组间比较,置管(喉罩)即刻及置管(喉罩)后3分钟DBP、MBP和HR差异均有统计学意义(P<0.05)。结论:在术中应用SLMA可以达到和气管插管一样的通气效果,而且安全可靠,可广泛应用。

Objective：IInvestigation of One-time Double-tube LMA Mask in clinical anesthesia and its indication of the safety and feasibility.Methods： Seventy-nine patients were selected in the general surgery,gynecology,orthopedics,neurosurgery and otorhinolaryngology,etc.The patients were randomly allocated to one-time dual laryngeal mask group（supreme laryngeal mask airway,SLMA） and the endotracheal intubation group（ET）,there were respectively 42 cases and 37 cases.There were recorded before induction of anesthesia,after induction,intubation（LMA）,immediately tube（LMA） after 3 minutes,extubation（LMA） before and extubation（LMA） after 3 minutes SBP,DBP,MBP,HR and SpO2,intraoperative propofol and fentanyl and vecuronium dosage.Results： The success rate of the first intubation were 97% and 95% in two groups,intraoperative fentanyl was no significant difference（P0.05）;Propofol and vecuronium dosages were significant difference in two groups（P0.05）,the ET group were more than the SLMA group;The recovery time in the ET group was significantly longer than the SLMA ET group,the difference was statistically significant（P0.05）;Before and after induction with the induction,SBP,DBP,and MBP were differences statistically significant in two groups,（P0.05）;Tube（LMA） instantly and tube（LMA） after 3 minutes,the SBP,DBP,MBP and HR differences were statistically significant in two groups,（P0.05）;The incidence of extubation cough or struggle response,postoperative sore throat and throat discomfort were higher in the ET group.Conclusion： SLMA can achieve the same ventilation and tracheal intubation effect,and it is safe and reliable,which can be widely applied.