SLIPA与经典喉罩的临床应用比较

Compare of SLIPA and Laryngeal Mask Airway

目的全麻下行择期妇科腹腔镜手术的病人,进行SLIPA(Streamlined Liner of the Pharynx Air-way)或经典喉罩(laryngeal mask airway,LMA)的应用效果比较。方法 60例病人随机分成两组,所有病人使用相同的麻醉药物。有食管胃反流危险因素的病人被排除。评估两种通气道应用的容易程度;呼吸道密封效果;通气情况;插管反应;副作用。结果 SLIPA或LMA均容易插入和通气,除了SLIPA有较大的峰值气道压,分别是16.2 cmH2O±3.8 cmH2O,13.4 cmH2O±2.3 cmH2O(P=0.03),其它参数比较无明显差异。平均呼吸道密封压分别是24.1 cmH2O±5.4 cmH2O,25.7 cmH2O±6.4 cmH2O(P=0.2)。SLIPA或LMA的密封质量:均能允许低流量麻醉,环路最低气流量分别为558 mL/min±377 mL/min,573 mL/min±382 mL/min(P=0.88)。插管反应:插入2 min后的血压,心率与基础值,诱导后的血压比较,两组均无显著性差异。24 h的咽痛发生率:两组相比无差异(P=0.95)。结论应用SLIPA或LMA进行控制通气,两种通气道均较容易插入,气道管理满意。

Objective To discuss the clinical effect of SLIPA and LMA. Methods 60 cases of gynaecological laparoscope were divided into two group except refluxing esophagitis. The observation was taken in easy degree, closed effect, reaction and side effect. Results SLIPA was similar with LMA in insert and ventilation but the great peak pressure of 16. 2 cmH20± 3.8 cmH20, 13.4 cmH20 ± 2.3 cmH20 （ P = 0. 03 ）, the average pressure were 24. 1 cmH20 ± 5.4 cmH20, 25.7 cmH20 ±6.4 emil20 （ P = 0.2） , the circle lowest flow volume were 558 mL/min ± 377 mlJmin ,573 mlJmin ±382 mL/min（P = 0. 88）. There was no significant difference between two groups in Bp, HR and pharyngodynia. Conclusion Both methods might have satisfied effect in clinic.