LMA双管喉罩全麻在腹腔镜胆囊切除术中的应用

Application of the proseal-LMA undergoing laparoscopic cholecystectomy during general anesthesia

目的：探讨双管喉罩全麻在腹腔镜胆囊切除术中应用的利弊。方法：60例ASAⅠ-Ⅱ级，无禁忌症的择期腹腔镜胆囊切除术患者，随机分为双管喉罩组（30例）和气管插管组（30例）。观察两组诱导后（T0），置喉罩（导管）即刻（T1），置罩（管）后3min（T2），切皮时（T3），拔罩（管）即刻（T4）时的SBP、DBP、HR、SpO2、PETCO2，以及术后不良并发症（咽痛、恶心、呕吐、反流、误吸）。结果：喉罩组T0与T1无差异，且喉罩组T1、T4时SBP、DBP、HR、PETCO2较气管组降低，两组术后观察均未出现反流、误吸，喉罩组4例出现咽痛，气管组10例出现咽痛，差异有统计学意义（P＆lt;0.05）。结论：双管喉罩全麻应用于腹腔镜胆囊切除术，可有效降低术中心血管反应及术后并发症，是安全、可行的麻醉方式。

Objective：To investigate the application of the proseal-LMA undergoing laparoscopic cholecystectomy during general anesthesia.Methods：Sixty ASAⅠ-Ⅱpatients,who had no contraindications for intubation and pros-eal-LMA,undergoing laparoscopic cholecystectomy under general anesthesia,were randomly assigned into the pros-eal-LMA group（30 cases） and the endotracheal tube group（30 cases）. SBP,DBP,HR, SpO2, PETCO2 were recorded after induction（T0）,at the time of proseal-LMA/ETT（T1）,3 min after LMA/ETT（T2）, at the time of cutting skin（T3） and extu-bation （T4）,the complications （pharyngalgia,nausea, vomit Regurgitation, aspiration）after operation were also recorded. Results：There was no difference between the point of T0, T1 in the proseal-LMA group. SBP,DBP,HR,PETCO2 of the proseal-LMA group at the point of T1, T4 were lower than the endotracheal tube group.There was no regurgitation and aspiration in two groups.Four cases pharyngalgia in proseal-LMA group,ten cases pharyngalgia in endotracheal tube group,and the two groups had statistical differences（P＆lt;0.05）. Conclusion：The proseal-LMA applying in laparoscopic cholecystectomy during general anesthesia is a safe and feasible anesthesia way,and can reduce the adverse cardio-vascular effects obviously,resulting in fewer complications.