丙泊酚在小儿喉罩置入麻醉诱导中的应用

Application of Propofol Anesthesia Induction in Pediatric Laryngeal Mask Insertion

目的：观察丙泊酚在小儿喉罩置入麻醉诱导中的应用效果。方法：选择2013年3月至2014年10月在本院进行择期手术患儿60例,年龄1~8岁,美国麻醉医师协会（ASA）分级Ⅰ~Ⅱ级,体重10~30 kg。常规禁食禁饮,术前30 min给予盐酸戊乙奎醚（0.01 mg/kg）。基础麻醉：咪达唑仑（0.03 mg/kg）和芬太尼（1μg/kg）静脉注射,分别给予丙泊酚2.0 mg/kg（A组,n=30）和3.0 mg/kg（B组,n=30）诱导,诱导前3 min静脉给予利多卡因1 mg/kg。在咽喉反射消失、下颌松弛、睫毛反射消失时用翻转法置入大小合适的喉罩。观察诱导前后血流动力学变化、并发症、喉罩首次置入成功率。结果：丙泊酚诱导后喉罩置入的首次成功率分别为28例（93.3%）和27例（90.0%）,差异无统计学意义（P〉0.05）。并可以建立安全有效的通气。麻醉后患者血压、心率均正常。结论：静脉注射咪达唑仑、芬太尼、利多卡因基础麻醉后,使用丙泊酚诱导置入喉罩具有较好的效果。

Objective： To observe the application of propofol in pediatric laryngeal mask insertion in anesthesia induction. Meth- ods： Sixty patients with pediatric surgery from Mar 2013 to Oct 2014, 1-8 years old, ASA I -Ⅱ , 10-30 kg weight were enrolled. Abstain routine fasting drink, YiKui hydrochloride ether （0. 01 mg/kg） was given peoperative 30 rain. Basic anesthesia was done by midazolam （0.03 mg/kg） and fentanyl intravenous injection （ 1 g/kg）, respectively. Propofol 2. 0 mg/kg （group A, n= 30）, and 3.0 mg/kg （ group B, n = 30） was given for anesthesia induction, 3 rain before induction, intravenous injection with lidoeaine 1 mg/kg was done. When the throat were flexia, jaw was flabby, eyelash reflex disappeared, the appropriate size of the laryngeal mask with the flip method was set. Hemodynamic changes before and after induction, complications and the success rate for the first time laryngeal mask insertion were observed. Results： The first time success rates of propofol induction laryngeal mask insertion were 28 cases （93.3%） and 27 cases （90. 0%）, there was no difference （P〉0. 05）, which could build a safe and effective ventilation. After anesthesia, blood pressure and heart rate were normal in patients. Conclusion： Base anesthesia with intravenous injection of midazolam and fentanyl and lidocaine, the use of propofol induction in laryngeal mask insertion has a good effect.