LMA supreme和欧普乐喉罩用于老年患者全身麻醉气道管理的比较

目的比较LMA supreme和普乐喉罩用于老年患者全身麻醉泌尿外科手术术中气道管理的效果。方法择期全身麻醉下行泌尿外科手术老年患者60例，采用随机数字表法分为LMA supreme组（S组）和欧普乐组（O组），每组各30例。记录两种喉罩的首次置入成功率、置入时间、口咽腔漏气压、术中通气不足及并发症的发生情况。结果S组有1例患者3次置入喉罩均失败，被排除。S组和O组首次置入成功率分别为23例（79.3％）和25例（83．3％），喉罩成功置入时间分别（19．3±5．3）s和（16．0±4．6）s，口咽腔漏气压分别是（21．2±3．5）cmH2O和（23．0±2．9）cmH2O。O组喉罩置入时间短于S组（P〈0．05），口咽腔漏气压高于S组（P〈0．05），术中。组较S组通气不足发生情况明显减少（P〈0．05）。两组喉罩首次置入成功率和并发症发生情况差异无统计学意义（P〉0．05）。结论LMA supreme和欧普乐喉罩均可安全有效用于老年患者泌尿外科全身麻醉气道管理，欧普乐喉罩优于LMA supreme。

Objective To compare the efficacy of LMA supreme and OPLAC for the airway management in elderly patients underwent elective urologic surgery. Methods A total of 60 patients, ASA physical status I to m, scheduled for elective urologic surgery under general anesthesia were randomly divided into two groups （ n=30 ） using a random number table： LMA supreme group （ group S ） and OPLAC group （ group O ） . The insertion success rate on the first attempt, time for insertion, oropharyngeal leak pressure, intraoperative inadequate ventilation and complications were recorded. Results One patient in group S was excluded due to the failure of laryngeal mask insertion after three attempts. There was no significant difference in the insertion success rate on the first attempt （ 79.3 vs 83.3%, P〉0.05 ） . Compared with group S, the time for insertion was shorter in group O （ 19.3 ± 5.3 vs 16.0 ± 4.6 seconds, P〈0.05 ） ; oropharyngeal leak pressure was higher in group O （ 21.2 ± 3.5 vs 23.0 ± 2.9 ） cmH2O, P〈0.05 ） . During the surgery, inadequate ventilation events occurred obviously decreased in group O than in group S. The incidence of complications were comparable between two groups. Conclusion Both LMA supreme and OPLAC can provide adequate ventilation undergoing elective urologic surgery in elderly patients. The efficacy of OPLAC is better.