SLIPA喉罩在老年患者侧卧位全麻手术中的应用

Application of SLIPA during general anesthesia for aged patients in lateral position

目的观察SLIPA喉罩在老年患者侧卧位全麻手术中的应用效果。方法行人工全髋置换术老年患者60例随机均分为SLIPA喉罩组(S组)和气管插管组(G组)。麻醉期间常规监测HR、SBP、DBP。记录喉罩或气管导管插入次数、成功率。每15分钟记录SpO2、PETCO2、气道压峰值,以及麻醉时间、手术时间、拔管时间、苏醒时间、拔管后不良反应。结果 S组插管即刻、拔管即刻HR明显慢于G组,SBP、DBP均明显低于G组(P<0.05)。S组拔管时间、苏醒时间均短于G组(P<0.05)。S组拔管后无呛咳,G组有9例(30%)呛咳(P<0.05)。两组咽喉痛发生率无差异,且两组均无反流误吸发生。结论老年患者侧卧位全麻手术中SLIPA喉罩与气管插管通气效果相同,心血管反应更小,不良反应更少。

Objective To observe the effect of streamlined liner of pharyngeal airway （SLIPA） application during general anesthesia for aged patients in lateral position. Methods Sixty aged patients undergoing hip replacement were equally randomized into SLIPA group （group S） and tracheal tube group （group G）. HR, SBP and DBP were routinely monitored during anesthesia. The insertion times and success rates of SLIPA or endotracheal tube were recorded. SpO2, PgrCO2, and peak airway pressure every 15 minutes, the duration of anesthesia, operation, extubation, anesthesia emergence, and the side ffects after extubation were recorded. Results HR, SBP, and DBP was lower in group S than in group G at the time of intubation and extubation （P^0. 05）. The duration of extubation and anesthesia emergence were shorter in group S than in group G （P%0. 05）. There was no patient coughing in group S compared with 9 patients （30%） in group G （P〈0.05）. There was no significant difference of postoperative throat-pain between the two groups. None of reflux or aspiration happened in either group. Conclusion SLIPA can provide the same effective ventilation as the tracheal intubation with lower cardiovascular reaction and less side ffects during general anesthesia in aged patients in lateral position