不同型号Supreme喉罩用于腹腔镜手术患者充气容量的比较

Effect of cuff volume of different sizes of supreme laryngeal mask in patients undergoing laparoscopic surgery

目的探讨不同型号Supreme喉罩用于腹腔镜手术患者气道管理时合理充气容量。方法择期全身麻醉下行腹腔镜胆囊切除手术患者60例，美国麻醉医师协会（ASA）Ⅰ或Ⅱ级，MallampatisⅠ-Ⅲ级，根据使用Supreme喉罩型号不同分为3组，各20例。S组体重30—50kg使用3号Supreme喉罩；M组体重51—70kg，使用4号Supreme喉罩；L组体重〉70kg，使用5号Supreme喉罩。记录满足正压通气情况下的气道密封压、套囊充气容量、术中脉搏血氧饱和度（SpO2）、呼气末二氧化碳分压（PETCO2）、气道峰压（Ppeak）及拔除喉罩后不良反应的发生情况。结果满足正压通气情况下各组的气道密封压、套囊充气容量S组分别为（24．2±3．8）cmH2O（1cmH2O=0．098kPa）、（12．4±4．5）ml，M组（23．54．4．2）cmH2O、（11．3±3．5）ml，L组（27．0±2．8）cmH2O、（14．4±3．5）ml，组间相比差异无统计学意义；各时间点SpO2、PETCO2、Ppeak均在正常范围内，组间差异无统计学意义（P〉0．05）；拔除喉罩后呛咳、咽喉痛等不良反应的发生情况（S组4例、M组3例、L组3例），组间相比差异无统计学意义（P〉0．05）。结论Supreme喉罩用于腹腔镜胆囊切除手术患者适宜充气容茸为10～15ml。

Objective To explore the reasonable cuff volume of different sizes of laryngeal mask airway supreme in patients undergoing laparoscopic surgery. Methods Sixty ASA Ⅰ orⅡ patients aged 18 -72 years old undergoing elective laparoscopic cholecystectomy were divided into three groups according to the size of laryngeal mask （LMA） supreme （n=20 each）：3 size （group S,weighing 30-50 kg）, 4 size （group M, weighing 50-70 kg）, 5 size （group L,weighing 〉 70 kg）. Mallampati test was performed before operation in all groups. The patients were classified as Ⅰ - Ⅲ. The airway sealing pressure and cuff volume of positive ventilation were recorded. SpO2, PET CO2, Ppeak airway pressure and complications were recorded as well. Results The airway seal pressure and cuff volume were （24.2 ±3.8）cm H2O, （12.4 ±4.5）ml, （23.5 ±4.2）cm H2O, （11.3 ±3.5）ml, （27.0±2.8）cm H2O, （ 14.4 ±3.5 ） ml respectively and there were no significant differences among all groups. There were no significant differences of SpO2, PETCO2, Ppeak airway pressure and complications among groups. Conclusion The reasonable cuff volume of LMA supreme in patients undergoing laparoscopic cholecystectomy may be 10-15 ml.