i-gel喉罩联合T型密封管控制通气在无痛支气管镜检查中的应用

Application of i-gel laryngeal mask combined with T-seal adapter in painless bronchoscopy

目的:观察i-gel喉罩控制通气在无痛支气管镜检查中的应用效果。方法:选取拟行纤维支气管镜检查的患者80例,随机分为控制通气组(A组,n=40)和表面麻醉组(B组,n=40)。前者应用芬太尼、瑞芬太尼、丙泊酚、琥珀胆碱麻醉,i-gel无囊喉罩联合T型密封接头实施控制通气,后者应用利多卡因表面麻醉,自主呼吸,鼻导管给氧。记录两组患者在支气管镜检查中生命体征变化,镜检期间体动、咳嗽、喉痉挛等内镜相关不良反应和术后呛咳、声嘶等麻醉相关不良反应,镜检时间,患者满意度。结果:与表现麻醉组相比,控制通气组生命体征波动小(P<0.05),不良反应少(P<0.05),患者满意度高(P<0.05)。结论:i-gel喉罩控制通气在无痛支气管镜检查安全,有效控制气道,解决呼吸抑制问题,是内镜检查中一项可行的方法。

Objective To observe the clinical effect of controlled ventilation with i-gel laryngeal mask airway in painless bronchoscopy. Methods 80 patients were randomly divided into control group （group A, n = 40） and surface anesthesia group （group B, n = 40）. Fent-anyl, ruifentanyl, propofol, succinylcholine anesthesia and controlled ventilation was adopted by i-gel laryngeal mask combined with T-seal adapter in control group.Surface of lidocaine anesthesia, spontaneous breathing, nasal cannula oxygen were applied in surface anesthesia group. Patients vital signs change in bronchoscopy, endoscopic related adverse reactions such as body movement, cough, laryngospasm, anesthesia related adverse reactions such as postoperative bucking, choking hoarseness, examination time and patient satisfaction were recorded. Results Controlled ventilation with i- gel laryngeal mask shows airway changes are small （P 〈 0.05）, and less adverse reaction （P 〈 0.05）. Patients showed higher satisfaction （P 〈 0.05）. Conclusion controlled ventilation with i-gel laryngeal mask in painless bronchoscopy is safe, controls the airwayeffectively, and solve the problem of respiratory depression, which proves to be a feasible method.