双管喉罩通气舒芬太尼全麻对老年危重患者手术血流动力学的影响

Effect of proseal laryngeal mask airway for Sufentanil general anesthesia surgery on the hemodynamics of elderly critically ill patients

目的探讨双管喉罩通气舒芬太尼全麻对老年危重患者手术血流动力学的影响。方法择期舒芬太尼全麻老年危重患者40例随机分为双管喉罩组(PLMA组)和气管插管组(TT组)。记录麻醉诱导前(T0)、PLMA与TT置入和拔除前后(T1～7)患者的平均动脉压(MAP)及心率(HR)的数值,记录两组丙泊酚的用药量及麻醉并发症。结果两组在T0、T1、T4时的MAP和HR值比较差异无统计学意义(P>0.05),而在T2、T3、T5、T6、T7时PLMA组的MAP和HR值显著低于TT组(P<0.01,P<0.05)。组内比较:PLMA组麻醉后各时点MAP和HR较平稳;TT组麻醉后各时点MAP和HR波动明显。PLMA组丙泊酚用量为(260±35)mg,比TT组[(350±47)mg]减少(P<0.05)。PLMA组并发症低于TT组(P<0.01)。结论双管喉罩通气舒芬太尼全麻具有用药量少、对全身影响小、血流动力学平稳、并发症少的优点,可安全用于高龄体弱危重患者。

Objective To investigate the effect of proseal laryngeal mask airway for Sufentanil general anesthesia surgery on the hemodynamics of elderly critically ill patients.Methods 40 cases of elderly critically ill patients used Sufentanil general anesthesia were randomly divided into proseal laryngeal mask airway group（PLMA group） and tracheal intubation group（TT group）.The values of mean arterial pressure（MAP） and heart rate（HR） before induction of anesthesia（T0）,before and after PLMA and TT implantation and extubation（T1-7） were recorded.And the dosage of Propofol and anesthetic complications in two groups were recorded too.Results The MAP and HR values on T0,T1,T4 between two groups were not significantly different（P 0.05）,while the MAP and HR values of PLMA group patients on T2,T3,T5,T6,T7 were significantly lower than that of TT group（P 0.01,P 0.05）.Intra-group comparison： the MAP and HR value of PLMA group at each point-in-time after anesthesia were steady.But that of TT group fluctuated significantly.The Propofol dosages of PLMA group patients [（260＋35） mg] were less than that of TT group [（350＋47 mg）]（P 0.05）.And the complications of PLMA group patients were lower than that of TT group（P 0.01）.Conclusion Proseal laryngeal mask airway for Sufentanil general anesthesia has several advantages,such as less dosage,little systemic effect,stable hemodynamics,few complications.And it is safe for elderly critically ill patients.