食道堵塞型通气管(EOA)法全麻在腹腔镜胆囊切除术中的应用

Application of Eso-phageal Obturator Airway(EOA)in Laparoscopic Cholecystectomy under General Anesthesia

目的探讨食道堵塞型通气管(EOA)全麻在腹腔镜胆囊切除手术中应用的有效性和安全性。方法 50例择期腹腔镜胆囊切除术患者,ASAⅠ～Ⅱ级,年龄22～70岁,随机均分为气管导管组(T组)和食道堵塞型通气管组(E组)。观察患者入室后10min(T1)、插管前(T2)、插管后1min(T3)、5min(T4)、气腹前(T5)、气腹后15min(T6)、30min(T7)和拔管即刻(T8)的血压(BP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PetCO2)和气道峰压(Paw),在插管后和手术中进行胃张力评分,记录气腹时间和麻醉时间及拔管和术后并发症。结果两组患者T组较E组插管时循环系统波动大(P<0.01),胃张力评分高(P<0.01)且拔管时呛咳发生率高(P<0.01),麻醉诱导及清醒拔管时间长(P<0.01)和术后咽痛发生率高(P<0.05);E组较T组PetCO2、Paw高(P<0.01),但其均在正常范围。结论食道堵塞型通气管(EOA)法全麻可安全有效地应用于腹腔镜胆囊切除手术。

Objective To study the efficiency and safety of EOA in Laparoscopic cholecystectomy. Methods Fifty patients, from 22 to 70 years old, ASA class Ⅰ～Ⅱ, scheduled for Laparoscopic cholecystectomy operation under general anesthesia, were studied and randomly divided into endotracheal intubation group （T Group） and EOA group （E Group）, with 25 cases each. BP, HR, SPO2, PetCO2 and Paw were monitored and recorded at the time following： 10 minutes after they went into operation room （T1）, the time before the endotracheal intubation （T2）, 1 minutes after endotracheal intubation （T3）, 5 minutes after endotracheal intubation （T4）, the time before the aeroperitoneum （T5）, 15 minutes after the aeroperitoneum （T6）, 30 minutes after the aeroperitoneum （T7）, and the time of extubation（T8）. Score the gastric tension after intubation and in operation. Record the aeroperitoneum time, the anesthesia time, extubation complications, and postoperative complications. Results Compared with those in E Group, the index of circulation system in T Group significantly changed （P 0.01）, the score of gastric tension was higher （P 0.01）, the incidence level of cough in intubation was higher （P 0.01）, the time of anesthesia induction and awake extubation was longer （P 0.01）, the incidence level of postoperative sore throat was higher （P 0.05）. PetCO2 and Paw in E Group were higher than those in T Group, but all were in normal range. Conclusion It is effective and safe for EOA to apply in laparoscopic cholecystectomy operation.