喉罩通气麻醉在胸腔镜下肺部手术中的应用

Clinical application of thoracoscope pulmonary operation with the laryngeal mask anesthesia

目的探讨非气管插管麻醉在胸腔镜肺部手术中的临床应用价值。方法选择周围型肺结节患者48例,根据麻醉方式的不同分为经喉罩通气全身麻醉组(喉罩组)25例与双腔插管全身麻醉组(插管组)23例,比较2组麻醉、术中及术后观察指标,评估非气管插管麻醉下肺部手术的安全性及可行性。结果 2组患者均顺利完成胸腔镜下手术,无中转开胸病例。喉罩组术前麻醉时间、复苏时间、进食时间短于插管组,复苏时呛咳、术后咽部不适发生率低于插管组,差异有统计学意义(P<0.05)。结论非气管插管下肺部手术安全可行,在术前麻醉时间、麻醉用药量、术后复苏及降低术后咽部并发症等方面有明显优势,值得在肺部手术中推广。

Objective To investigate the clinical value of non tracheal intubation anesthesia in thoracoscopic pulmonary surgery.Methods Forty-eight cases of lung tumor by thoracoscope surgery were divided into two groups.Thoracoscope pulmonary operation with laryngeal mask anesthesia was performed in 25 cases of laryngeal mask group and thoracoscope pulmonary operation with double-lumenendo tracheal intubation anesthesia was performed in 23 cases of intubation group,then overall effects were compared.Results Thoracoscope surgery were successfully completed with all patients,no case was transferred to open chest operation.In laryngeal mask group,the preoperative anesthesia time was shorter,anesthetics dosage was less,postoperative recovery time was shorter,and the incidence of postoperative pharynx complication was lower when compared with the intubation group,and the difference was statistically significant(P<0.05).Conclusion The laryngeal mask airway anesthesia was safe and feasible in pulmonary operation,significant advantage could be observed in the preoperative anesthesia and postoperative recovery time and reducing postoperative throat complication,so it could be wide used in lung operations.