双管喉罩在小儿眼科手术中应用的临床研究

Clinical Research on the Application of Double-barreled Laryngeal Mask on Pediatric Ophthalmology Surgery

目的:研究双管喉罩(PLMA)在小儿眼科麻醉中应用的可行性和安全性。方法:择期小儿眼科手术患者180例,随机均分为(P组)双管喉罩组、(L组)普通喉罩组、(T组)气管插管组。记录麻醉诱导前(T0),置入喉罩(导管)后(T1),手术开始1分钟后(T2),手术刺激最强(T3),拔出喉罩(导管)前(T4),出手术室前(T5),的心率(HR),平均动脉压(MAP),脑电双频指数(BIS)值。记录手术时间、拔管时间、麻醉药用量(丙泊酚用量)、苏醒时间及拔管后不良反应(呛咳、低氧血症、喉痉挛、声音嘶哑、咽喉痛)。结果:P组、L组喉罩一次性置入成功率高于T组气管导管一次性插入成功率。P组和L组丙泊酚用量明显低于T组(P<0.05)。与T组比较P组、L组在T1、T2、T3、T4时HR较慢,MAP较低,BIS值较高(P<0.05),T组血流动力学波动明显大于P组、L组。P组和L组苏醒时间明显短于T组(P<0.05)。结论:在小儿眼科手术麻醉中,PLMA放置成功率高,血流动力学平稳,术中通气情况良好,发生反流、误吸、分泌物增多等并发症少,苏醒迅速,是一种安全有效的麻醉方法。

Objective： To discuss the feasibility and safety of double-barreled laryngeal mask airway（PLMA） applied to pediatric ophthalmology anesthesia surgery.Methods： 180 patients with elective pediatric ophthalmology surgery were randomly divided into the LMA group（P）,double-barreled ordinary LMA group（L group）,intubation group（T group）.Recorded before induction of anesthesia（T0）,placing LMA（catheter） to the strongest（T1）,one minute after the start of surgery（T2）,surgical stimulation（T3）,unplug the laryngeal mask（catheter） before（T4）,athe operating room（T5）,heart rate（HR）,mean arterial pressure（MAP）,the bispectral index（BIS） values.Recorded operative time,time to extubation,decreased anesthetic（propofol dosage）,waking time and extubation adverse reaction（cough,hypoxemia,laryngospasm,hoarseness,sore throat）.Results： P group,L group laryngeal mask disposable T endotracheal tube placement success rate,one-time insertion success rate.P and L group was significantly lower than the dose of propofol T group（P 0.05）.T group,P group,L group at T1,T2,T3,T4 HR slower,MAP is lower,the BIS value was higher（P 0.05）,The hemodynamic fluctuations T group was significantly greater than the P group,L group.P and L groups awake time is significantly shorter than the T group（P 0.05）.Conclusion： The pediatric ophthalmology anesthesia,PLMA placed a high success rate,hemodynamic stability,good ventilation surgery dimensional reflux occurs,aspiration,increased secretions fewer complications,Wake up quickly,is a safe and effective method of anesthesia.