喉罩全身麻醉在30例甲状腺瘤切除术中的应用临床观察

Clinical application of laryngeal mask anesthesia in 30 cases of thyroidectomy

[背景]观察喉罩全身麻醉在甲状腺瘤切除术中的应用效果.[病例报告]选择在全身麻醉下行甲状腺瘤切除术的患者60例,ASA分级为1~2级,未见有明显的心血管系统疾病和呼吸系统疾病.将60例患者随机分为喉罩组（H组）和气管内插管组（Q组）,每组各为30例.给H组患者插入喉罩,给Q组插入气管内导管,观察两组麻醉诱导期、维持期、苏醒期的血压、心率、麻醉维持期的气道压力及苏醒期躁动、呛咳情况.结果见,与Q组比较,H组麻醉诱导期、苏醒期的血压及心率明显降低（P〈0.05）,苏醒期躁动、呛咳次数明显减少（P〈0.05）,两组麻醉维持期的气道压力间差异无统计学意义（P〉0.05）;两组均未见发生呼吸道梗阻等呼吸道不通畅情况.[讨论]喉罩全身麻醉下行甲状腺瘤切除术时血压、脉搏较平稳,苏醒期躁动和呛咳较少.甲状腺瘤切除术中喉罩全身麻醉是比较安全可靠的麻醉方法.

BACKGROUND To observe the clinical effects of laryngeal mask anesthesia on thyroid adenoma resection. CASE REPORTS 60 cases of patients with thyroidectomy under general anesthesia were selected. Their ASA class was Ⅰ,Ⅱ , and they did not have significant cardiovascular and respiratory system diseases. They were randomly divided into laryngeal mask group （H group） and endotracheal intubation group （Q group）, 30 cases in each group. The patients in Laryngeal mask group were inserted laryngeal mask, and the patients in endotracheal intubation group were inserted the endotracheal tube. The blood pressure and pulse during the induction, maintenance and recovery period were observed, and the airway pressure during maintenance period and dysphoria and bucking during recovery period were also observed. The results showed that as compared with the Q group the blood pressure and pulse during the induction and recovery period in the H group were significantly decreased （P〈0. 05）, and dysphoria and bucking times during recovery period were significantly reduced（P〈0.05）. There was no significant difference in airway pressure between H group and Q group during the period of anesthesia maintenance （P〉 0.05）. The respiratory tract obstruction did not occur in the two groups. DISCUSSION The blood pressure and pulse were stable, and dysphoria and bucking during recovery period were less in thyroidectomy under the laryngeal mask anesthesia. Laryngeal mask anesthesia was a safe and reliable method of anesthesia in thyroidectomy