SLIPA喉罩在全身麻醉气道管理中的应用体会

The application of the SLIPA in laryngeal mask airway management during general anesthesia

目的探讨Streamlined Liner of the Pharynx Airway(SLIPA)喉罩在全身麻醉气道管理中的应用。方法选择ASAⅠ-Ⅲ级,无困难气道的择期全麻手术的成年患者60例,随机分为SLIPA组(S组)和气管导管组(T组),每组30例。所有患者均以咪达唑仑0.05mg/kg、芬太尼2.5μg/kg、维库溴铵0.1mg/kg、丙泊酚1.5mg/kg进行全麻诱导后行SLIPA喉罩或气管导管插管,建立人工气道后行机械通气,设定通气潮气量为8mL/kg,频率为12次/min,吸呼比为1:2。术中持续输注丙泊酚4-2mg/(kg.h)、瑞芬太尼20-5μg/(kg.h)维持麻醉,每30min静注0.04mg/kg的维库溴铵。记录建立人工气道的平均时间、全麻诱导后建立人工气道前以及建立人工气道后1min、10min、30min时的MAP,HR,SpO2,气道压(Kpa)值,以及拔除人工气道后1min时MAP,HR,SpO2值。并随访记录患者术后咽喉疼痛、声音嘶哑发生情况。结果 SLIPA喉罩在建立和拔除人工气道时MAP及HR较气管插管组稳定(P<0.05)。结论 SLIPA喉罩使用方便,安全性高,可安全的运用于平卧位手术全身麻醉中建立人工气道。

【Objective】 To investigate the Streamlined Liner of the Pharynx Airway（SLIPA） laryngeal mask airway management during general anesthesia in the application.【Methods】 ASA Ⅰ-Ⅲ grade,non-elective difficult airway anesthesia in adult patients 40 cases were randomly divided into SLIPA group（S group） and the tracheal tube group（T group）,20 cases each.All patients are midazolam 0.05mg/kg,fentanyl 2.5μg/kg,vecuronium 0.1mg/kg,1.5mg/kg of propofol induction of general anesthesia underwent SLIPA laryngeal mask or tracheal intubation,the establishment of artificial airway underwent mechanical ventilation,tidal volume ventilation was set 8ml/kg,Frequency of 12 times / min,respiratory ratio of 1：2.Intraoperative infusion of propofol 4-2mg /（kg.h）,remifentanil 20-5μg /（kg.h） the maintenance of anesthesia,intravenous injection of 0.04mg/kg per 30min of vecuronium.Establishment of artificial airway record the average time after induction of general anesthesia before and the artificial airway artificial airway after 1min,10min,30min when the MAP,HR,SpO2,airway pressure（Kpa） values,and the removal of artificial airway When,after 1min MAP,HR,SpO2 value.And postoperative follow-up records of sore throat,hoarseness were observed.【Results】 The SLIPA in the establishment and removal of artificial airway when tracheal intubation MAP and HR compared with stable group（P 0.05）.【Conclusion】 The SLIPA easy to use,safe,can be applied to the safety of general anesthesia in the supine surgical artificial airway.