喉罩复合无肌松麻醉对脑动脉瘤栓塞术应激的影响

Effect of laryngeal mask without muscle relaxant on stress caused by cerebral aneurysm embolization

目的探讨喉罩复合无肌松麻醉对脑动脉瘤栓塞术应激的影响。方法选择实施脑动脉瘤栓塞术的患者80例,将其随机分为观察组和对照组各40例,观察组应用喉罩复合无肌松麻醉,对照组应用气管插管联合肌松药麻醉,比较诱导前(T0)、诱导后插管或喉罩前(T1)、插管或喉罩时(T2)、置入插管或喉罩1 min时(T3)两组患者的心率、平均动脉压及其血糖和皮质醇的变化情况。结果观察组麻醉诱导期间心率和平均动脉压及血糖和皮质醇变化差异无统计学意义(P>0.05),对照组T1、T2、T3时间点的心率显著快于T0时间点(P<0.05),平均动脉压显著高于T0时间点(P<0.05),血糖和皮质醇水平均显著高于T0时间点(P<0.05)。结论喉罩通气复合无肌松平衡麻醉应用于脑动脉瘤栓塞术,能显著降低患者应激反应,维持循环功能稳定。

Objective To explore the effect of laryngeal mask without muscle relaxant on stress caused by cerebral aneurysm embolization. Methods 80 patients who would received cerebral aneurysm embolization were selected and randomly divided into observation group and control group,with 40 cases in each group.Laryngeal mask without muscle relaxant was given to the observation group,and tracheal intubation combined with muscle relaxant was given to the control group.Changes of heart rate,average arterial pressure,blood sugar and cortisol at the time of before induction （T0）,before intubation or laryngeal mask after induction （T1）,intubation or laryngeal mask （T2）,placed intubation or laryn-geal mask 1 min （T3） of the two groups were compared. Results Differences of the changes of heart rate,average arterial pressure,blood sugar and cortisol during anesthesia induction in the observation group were not significant （P〉0.05）.The heart rate at T1,T2 and T3 in the control group was faster than that at T0 （P〈0.05）,and average arterial pressure was high-er than that at T0 （P〈0.05）.Levels of blood sugar and cortisol at T1,T2 and T3 in the control group were higher than those at T0 （P〈0.05）. Conclusion Laryngeal mask without muscle relaxant applied in cerebral aneurysm embolization can sig-nificantly decrease the patients’stress and maintain stable circulatory functions.