浅论喉罩通气全麻复合硬膜外阻滞麻醉在妇科腹腔镜手术中的应用效果

The Application of Laryngeal Mask Airway General Anesthesia Combined with Epidural Block in Laparoscopic Surgeries in gynaecology

目的 ：探讨喉罩通气全麻复合硬膜外阻滞麻醉在妇科腹腔镜手术中的应用效果。方法 ：将2014年1月~2016年1月期间在我院进行妇科腹腔镜手术的66例患者作为本次研究的对象。我们对这66例患者均进行喉罩通气全麻复合硬膜外阻滞麻醉,然后观察其一次性置入喉罩的成功率、麻醉效果持续的时间、手术的用时、拔除喉罩时发生不良反应的情况、术中的心率和血压的变化情况、拔除喉罩所用的时间、恢复清醒所用的时间及其恢复自主呼吸所用的时间。结果 ：1）在这66例患者中,有64例患者一次性置入喉罩成功,其一次性置入喉罩的成功率为97%。这66例患者麻醉效果持续的平均时间为（44.5±10.4）min,手术的平均用时为（40.3±12.6）min。在拔除喉罩时,有2例患者出现了轻微的喉部疼痛,有2例患者出现了恶心、呕吐,其不良反应的发生率为6.25%（4/64）。2）在喉罩置入前1min、置入时及拔除后1min,这66例患者的心率和血压均无明显的变化,组间相比差异无统计学意义（P〉0.05）。3）这66例患者拔出喉罩所用的平均时间、恢复清醒所用的平均时间及其恢复自主呼吸所用的平均时间分别为（4.0±1.4）min、（7.7±5.1）min和（27.4±6.8）min。结论 ：喉罩通气全麻复合硬膜外阻滞麻醉在妇科腹腔镜手术中的应用效果较好,具有操作简单、麻醉的效果好、对患者循环功能的影响小及安全性高等优势。

Objective： To observe and analyse the effect of laryngeal mask airway general anesthesia combined with epidural block in laparoscopic surgeries in gynaecology.Methods：We chose 66 patients as samples according to the inclusion and exclusion criteria. All patients were operated with laparoscopic surgery while taken laryngeal mask airway general anesthesia combined with epidural block. The hemodynamic changes before and after laryngeal mask airway insertion were recorded. Results：One-time success rate of laryngeal mask insertion was 97.0%. 2 cases of mild sore throat and 2 cases of nausea and vomiting appeared when laryngeal mask was removed. There was no significant change in patients＇ average heart rate, diastolic pressure and systolic pressure 1 min before laryngeal mask insertion, during insertion and 1min after removal（P0.05）. Extubation time was（4.0±1.4） min, awake time was（7.7±5.1） min and respiratory restoration time was（27.4±6.8） min. Conclusion：Laryngeal mask airway general anesthesia combined with epidural block is effective in laparoscopic surgeries and deserves popularization and application.