Supreme喉罩全麻在小儿斜视手术中的应用

Application of Supreme Laryngeal Mask Airway in Pediatric Strabismus Surgery

目的探讨Supreme喉罩全麻在小儿斜视手术的临床麻醉效果。方法选取2013年4月—2014年4月该院收治的拟择期行斜视矫正术的患儿76例,年龄2-6岁,体重10-20 kg,随机分为两组。ETT组采用气管插管麻醉（n=38例）,LMA组采用Supreme喉罩全身麻醉（n=38例）,比较两组的麻醉效果。结果 LMA组麻醉时T2心率为（113.8±9.1）次/min、T3心率为（110.7±7.8）次/min、T4心率为（112.8±8.3）次/min,均低于同一时点ETT组心率（P〈0.05）;LMA组平均动脉压T2为（79.8±5.0）mm Hg、T3为（78.2±5.6）mm Hg、T4为（80.2±5.5）mm Hg,和同一时点ETT组相比差异有统计学意义（P〈0.05）;两组置管前后Sp O2和Pmax差异无统计意义（P〉0.05）;两组患儿均未出现不良反应。结论 Supreme喉罩操作简便、对血流动力学影响小,术中通气效果良好,可安全应用于小儿斜视手术。

Objective To study the clinical anesthetic effect of supreme laryngeal mask airway （LMA） in children undertaking strabismus surgery. Methods Seventy-six children admitted to this hospital from April 2013 to April 2014 aged 2 to 6 years, weighed 10 to 20 kg, scheduled for elective strabismus surgery were randomly divided into two groups： LMA group （n=38） and ETT group （n=38）. The ETT group were given tracheal intubation anesthesia, and the LMA group were given general anesthesia with supreme laryngeal mask airway. And the anesthetic effect of the two groups was compared. Results The mean heart rate of LMA group at T2 was（113.8＋9.1） times/min, at T3 was（110.7±7.8） times/min, at T4 was （112.8±8.3） times/min, lower than that of the ETT group at time point T2, T3, T4, respectively, （P〈0.05）; the mean arterial pressure of LMA group was （79.8±5.0） mmHg at T2, （78.2±5.6） mmHg at T3, （80.2±5.5） mmHg at T4, compared with that of the ETT group at time point T2, T3, T4, respectively, the differences between the groups were statistically significant（P〈0.05）; the SpO2 and Pmax of the two groups after intubation did not differ signif- icantly from preoperative baseline values（P〉0.05）. No adverse reactions occurred in both groups. Conclusion The supreme LMA is easy to operate with little effect on the hemodynamics and good intraoperative ventilation, so it can be applied to the pediatric strabismus surgery safely.