I-gel喉罩在高龄无牙患者侧卧位手术中呼吸管理的临床应用

Clinical Application of I-gel Laryngeal Mask in the Management of Respiratory Management in Elderly Patients with Lateral Eccentric Surgery

目的评价I-gel喉罩在高龄无牙患者侧卧位手术中呼吸管理的效果和安全性。方法方便选择该院2017年4月—2018年3月收治的年龄在80岁以上人工髋关节置换患者100例,ASA分级Ⅱ～Ⅲ级,按随机数字表法分为A组和B组,每组50例。A组于诱导2 min后置入I-gel喉罩,B组于可视喉镜下行气管内插管。记录喉罩或气管导管置入前、即刻、及插入后5 min,喉罩或气管导管拔除即刻、5 min患者的血压、心率、气道峰压,并记录患者术毕拔管后咽喉疼痛情况。结果两组患者在喉罩或气管插管即刻收缩压A组(126.8±11.1)mmHg明显低于B组(145.3±7.9)mmHg(t=-6.085,P<0.01),舒张压A组(73.1±4.7)mmHg明显低于B组(83.3±5.4)mmHg(t=-6.370,P<0.01),心率A组(60.5±2.3)次/min明显低于B组(70.3±3.5)次/min(t=-10.536,P<0.01)。拔除即刻收缩压A组(134.7±8.7)mmHg低于B组(147.1±7.9)mmHg(t=-4.070,P<0.05),舒张压A组(75.1±5.4)mmHg,低于B组(84.3±6.7)mmHg(t=-4.867,P<0.05),心率A组(63.5±3.5)次/分明显低于B组(72.5±3.6)次/分(t=-8.019,P<0.01)。术后咽喉痛A组(2例)明显低于B组(28例)(P <0.01)。结论 I-gel喉罩可安全用于高龄无牙患者侧卧位手术中的呼吸管理,且不良反应发生率低,有临床应用价值,值得推广使用。

Objective To evaluate the efficacy and safety of I-gel laryngeal mask in the management of respiratory management in elderly patients with edentulous lateral position. Methods Convenient select a total of 100 patients with artificial hip replacement who were over 80 years old from April 2017 to March 2018 were enrolled in the hospital. The ASA grade Ⅰ-Ⅰ-Ⅲ was divided into group A and group B according to the random number table, 50 cases in each group. Group A was placed in the i-gel laryngeal mask 2 minutes after induction, and group B was placed in the endotracheal tube under the visual laryngoscope. The pressure, heart rate, and peak airway pressure of the patient were removed immediately before, immediately, and 5 minutes after the insertion of the laryngeal mask or tracheal tube, and the pain of the patient was recorded immediately after extubation. Results In the two groups, the immediate systolic pressure of the laryngeal mask or tracheal intubation was significantly lower in group A （126.8＋11.1） mmHg than in group B （145.3＋7.9）mmHg （t=-6.085, P〈0.01）, and diastolic blood pressure group A （73.1±4.7）mmHg was significantly lower than group B （83.3±5.4）mmHg （t=-6.370, P〈 0.01）, heart rate group A （60.5±2.3）times/min was significantly lower than group B （70.3±3.5）times/min （t=-10.536, P〈0.01）. Immediate systolic blood pressure was removed from group A （134.7±8.7）mmHg lower than group B （147.1±7.9） mmHg （t= 4.707, P〈0.05）, diastolic blood pressure group A （75.1±5.4）mmHg, lower than group B （84.3±6.7）mmHg （t=-4.867, P〈0.05）, heart rate group A （63.5±3.5）times/min was significantly lower than group B （72.5±3.6）times/min （t=-8.019, P〈0.01）. Post-operative sore throat group A （2 cases） was significantly lower than group g （28 cases） （P〈0.01）. Conclusion The I-gel laryngeal mask can be safely used for respiratory management in elderly patients with edentulous lateral position surgery, and the incidence of adverse reactions is low. It has clinical application value and is worthy of popularization.