新型喉罩与气管插管在妇科腹腔镜全麻手术的对比研究

The study of comperation of laryngeal mask airway supreme and endotracheal intubation used with general anesthesia undergoing elective gynecological laparoscopy

目的比较新型Supreme喉罩与气管插管在妇科腹腔镜全麻手术中的应用效果及安全性。方法选择60例ASA为Ⅰ～Ⅱ级妇科腹腔镜全麻手术患者,随机分为S组(喉罩组,n=30)和T组(气管导管组,n=30)。观察对比两组术中血流动力学变化,记录麻醉诱导前(基础值)、插管(罩)前后、拔管(罩)前后等时点的HR、SBP、DBP的变化及麻醉合并症(包括呛咳、体动、返流、误吸及术后咽喉痛)。结果 T组插管和拔管期间的HR、BP均较插管前(基础值)升高(P<0.05),较S组明显地升高(P<0.05);S组则没有明显变化。S组患者在拔管期间呛咳、体动以及术后咽喉痛的发生明显少于T组(P<0.05)。两组其他合并症发生率差异无统计学意义(P>0.05)。结论 Supreme喉罩全身麻醉血流动力学平稳,在择期手术中是一种安全、有效、容易使用的声门上通气装置,可替代气管插管用于妇科腹腔镜手术。

Objective To compare the effects and safety of laryngeal mask airway supreme and endotracheal intubation in general anesthesia for elective gynecological laparoscopy.Methods 60 elective patients,ASA grade I^II,undergoing gynecological laparoscopy under general anesthesia were randomly allocated to two groups with 30 cases each.GroupS（n = 30） received laryngeal mask airway supreme（LMA Supreme） and group T（n = 30） received endotracheal tube（ETT）.The changes of HR,SBP,DBP of two groups were measured during intubation and extubation.The complications of anesthesia were recorded included bucking,body movement,countercurrent,aspiration and postoperative pharyngolaryngeal adverse events during each operation.Results HR,SBP,DBP were found higher than baseline in group T during intubation and extubation（P0.05）,and were also significantly higher than those in group S（P0.05）.HR,SBP,DBP were not significantly different at each point in group S（P0.05）.The patients bucking,body movement during extubation and postoperative sore throat in group S were found significantly lower than those in group T（P0.05）.The incidence of complication and adverse reactions in both groups was not significant（P0.05）.Conclusion General anesthesia with the LMA supreme has a stability on the hemodynamic change.It is a safe,efficacious and easy-to-use disposable supraglottic airway device in elective surgery,making it can be as a substitute for ETT undergoing gynecological laparoscopy.