双管型喉罩用于小儿短小手术的效果观察

The curative effect of double-tube laryngeal mask on fast-track surgery in pediatric patients

目的在小儿短小手术中使用双管型喉罩的优越性。方法把本院拟行短小手术的60例患儿随机分为双管喉罩组（A组）和气管插管组（B组），并采用相同的方法诱导，分别记录同时间点两组患儿诱导前后、置入喉罩，导管后1min、3min、5min，拔除喉罩，导管前及后5min的均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）、手术耗时、苏醒耗时、一次性置管的成功率及苏醒时和术后的麻醉并发症，并进行统计学分析。结果两组患儿的一般情况、诱导前后的MAP、HR、SPO2、手术耗时以及一次性插管成功率比较均无统计学差异（P〉0．05）；置管后及术后拔管时B组的MAP和HR明显低于A组（P〈0．05或P〈0．01）；A组苏醒期躁动、屏气和术后咽喉不适明显少于B组（P〈0．05）。结论喉罩置入易，创伤少，若能掌握好其适应证和加强术中通气监测，那无疑是小儿短小手术的理想选择。

Objective To explore the value of double-tube laryngeal mask in fast-track surgery in pedi- atric patients, Methods 60 pediatric patients scheduled for fast-track surgery were randomly divided into group of double-tube laryngeal mask （group A） and group of tracheal intubation （group B）, At the same time points, mean arterial pressure （MAP）, heart rate （HR）, oxyhemoglobin saturation （SpO2）, surgical duaration, awakening time, success rate of one-off tube placement and agitation after awakening were recorded in both groups before and after induction of anesthesia, 1,3, and 5 min after placement of laryngeal mask or tracheal tube, and 5 min before and after removal of laryngeal mask or tracheal tube were recorded. A statistical analysis was conducted. Results No statistical difference was observed between the two groups in general conditions, MAP, HR and Sp02 before and after induction of anesthesia, surgical duration, and success rate of one-off tube placement （P〉0.05）. MAP and HR were significantly lower in group B than in group A after placement or removal of tube （P 〈 0.05 or P 〈 0.01）. Conclusions Double-tube laryngeal mask is easy to apply and less invasive. It can be an ideal choice for anesthesia in fast-track surgery in pediatric patients if intraoperative ventilation monitoring is strengthened.