SLIPA喉罩用于静脉全身麻醉面颈部扩张皮肤修复术的临床观察

Clinical application of SLIPA under total intravenous anesthesia during reconstructive surgies used soft-tissue expander device in faciocervical region

目的:探讨SLIPA喉罩用于静脉全身麻醉面颈部扩张皮肤修复术的有效性和安全性。方法:40例择期行面颈部扩张皮肤修复术的患者,随机分为气管插管组(T组)和SLIPA喉罩组(S组)。麻醉诱导后T组行气管插管术,S组置入SLIPA喉罩。记录两组T0～T5的心率、平均动脉压(MAP)、脑电双频指数(BIS);记录T6～T8的平均气道压、气道峰压值、呼气末二氧化碳分压(PETCO2)及术后合并症的发生率。结果:两组心率、MAP、BIS在T2显著升高后渐渐恢复至T0水平;S组T2～T4的MAP均低于T组(P<0.05),而两组平均气道压、气道峰压值及PETCO2比较差异无统计学意义。S组各种合并症发生率明显低于T组(P<0.05)。结论:SLIPA喉罩用于静脉全身麻醉面颈部扩张皮肤修复术,安全方便,并发症发生率低。

Objective： To investigate the feasibility and safety of the application of SLIPA under total intrave- nous anesthesia during reconstructive surgeries used soft-tissue expander device in faciocervical region. Methods： Forty patients with reconstructive surgeries used soft-tissue expander device in faciocervical region were randomly assigned into SLIPA group （Group S） and endotracheal intubation group （Group T）. After standard intravenous anesthesia induction, the endotracheal intubation in Group T and SLIPA in Group S were performed. The heart rate, mean artery pressure （MAP）, and bispectral index （BIS） were recorded in two groups at T0, T1, T2, T3, T4, and T5. Pmean, Ppeak and post-apneic end-tidal carbon dioxide pressure （PETCO2） were assessed at T6, T7, and T8. The incidences of restlessness, postoperative nausea and vomiting, and intraoperative awareness were recorded. Results： The MAP, BIS and heart rates in both groups were significantly elevated T2 and recovered after- ward. The MAP, Heart rate and BIS in Group S were significantly lower than those in Group T at T2, T3 and T4 （P 〈 0. 05 ）. However, there was no significant difference revealed in PETCO2, Pmean or Ppeak between the two groups. But the adverse event incidence was significantly lower in Group S （ P 〈 0.05 ）. Conclusions ： Application of SLIPA under total intravenous anesthesia during reconstructive surgeries used soft-tissue expander device in facio- cervical region provides sufficient safety and feasibility.