喉罩通气全身麻醉在老年高血压患者的应用

Application of ventilation with laryngeal mask airway in the elderly with hypertension

目的观察喉罩通气全麻对老年高血压手术患者血压和心率的影响。方法择期全麻胆道手术患者40例,年龄65-94岁。患者均合并原发性高血压1-2级,术前血压控制在140/90mm Hg。随机均分为两组,采用喉罩通气(L组)和气管插管(T组)。比较两组麻醉诱导前(T1)、气管插管或置入喉罩前(T2)、后即刻(T3)、后3min(T4)、拔管或取出喉罩后即刻(T5)和取出后3min(T6)时的的BP和HR变化。结果与麻醉前和T组比较,L组喉罩置入和拔除后的收缩压(SBP)、舒张压(DBP)和HR均较平稳,但T组插管后或拔管后的SBP、DBP和HR均较插管前或L组明显升高(P<0.05或P<0.01)。结论与气管插管全麻比较,喉罩通气全身麻醉对老年高血压手术患者的BP和HR影响较小。

Objective To observe the effect of ventilation with laryngeal mask airway（LMA） on circulation during operation under general anesthesia in the elderly with hypertension. Methods Forty hypertensive patients aged 65-94 years old undergoing biliary tract surgery under general anesthesia were equally assigned into two groups of L（ventilated with LMA） and T（ventilated with intratracheal intubation）. The changes of systolic and diasystolic blood pressure（SBP and DBP） and heart rate（HR） were compared before anesthesia induction（T1）, before intubation or LMA placement （T2）, immediately after intubation or LMA placement （T3） and 3 min later （ T4 ）, immediately after extubation or LMA withdrawing（T5） and 3 rain later（T6）. Results Compared to T1, the SBP, DBP and HR at T3-T6 were not significantly changed in group L（P〈0. 05）, which in group T were significantly higher than those in group L（P〈0.05）. Conclusion Compared to general anesthesia with intratracheal intubation, ventilation with LMA has less effect on circulation during operation under general anesthesia in the elderly with hypertension.