喉罩加盐酸戊乙奎醚诱导小儿全身麻醉的效果

Application of laryngeal mask plus penehyclidine hydrochloride in general anesthesia in children

目的探讨喉罩加盐酸戊乙奎醚在小儿全身麻醉中的应用效果。方法选取2017年8月至2019年1月择期行全身麻醉手术的患儿110例作为研究对象,根据全身麻醉方法分为气管插管组(n=30)、喉罩A组(n=40)和喉罩B组(n=40)。喉罩A组采用喉罩+盐酸戊乙奎醚诱导,喉罩B组采用喉罩+阿托品诱导。比较三组患儿在诱导前(T0)、给药后置喉罩/气管内插管前(T1)、置喉罩/气管内插管后1 min(T2)、拔除喉罩/气管导管时(T3)收缩压(SBP)、舒张压(DBP)和心率(HR)变化。统计三组患儿苏醒期和术后呛咳、喉/支气管痉挛、躁动、误吸、术后24 h内咽喉痛、声音嘶哑、恶心呕吐等不良反应发生率以及手术时间和清醒时间。结果气管插管组患儿T2、T3时刻SBP、DBP、HR均较T0时刻显著升高(P<0.05),喉罩B组患儿T1、T2、T3时刻SBP、DBP、HR均较T0时刻显著升高(P<0.05),喉罩A组患儿T1、T2、T3时刻SBP、DBP、HR与T0时比较,差异未见统计学意义(P>0.05)。T1时刻喉罩B组SBP、DBP、HR均显著高于气管插管组和喉罩A组(P<0.05),T2时刻气管插管组SBP、DBP、HR均明显高于喉罩A组和喉罩B组,且喉罩B组明显高于喉罩A组(P<0.05);T3时刻气管插管组SBP、DBP、HR均明显高于喉罩A组(P<0.05)。喉罩A组苏醒期和术后不良反应总发生率均显著低于气管插管组和喉罩B组,且喉罩A组和喉罩B组手术时间及清醒时间均明显较气管插管组短(P<0.05)。结论喉罩加盐酸戊乙奎醚诱导小儿全身麻醉对血压、心率影响小,且手术时间及清醒时间较气管插管短。

Objective To investigate the effect of laryngeal mask plus penehyclidine hydrochloride on general anesthesia in children.Methods A total of 110 children undergoing elective general anesthesia from August 2017 to January 2019 in our hospital were enrolled. The patients were divided into tracheal intubation group(n=30) and laryngeal mask group A(n=40) and laryngeal mask group B(n=40) according to the general anesthesia method. The patients in laryngeal mask group A were induced by laryngeal mask+penehyclidine hydrochloride, and the patients in laryngeal mask group B were induced by laryngeal mask+atropine. Before induction(T0), after laryngeal mask/intratracheal intubation(T1), laryngeal mask/intratracheal intubation 1 min(T2), removal of laryngeal mask/tracheal catheter(T3), the systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) changes were recorded. The incidence of adverse reactions such as cough, laryngeal/bronchial spasm, restlessness, aspiration, sore throat, hoarseness, nausea and vomiting within 24 hours after operation, operation time and waking time were counted.Results The levels of SBP, DBP and HR at T2 and T3 were significantly higher than those at T0(P<0.05). SBP, DBP and HR at T1, T2 and T3 in group B were significantly higher than those at T0(P < 0.05), while SBP, DBP and HR at T1, T2 and T3 in group A were not significantly different from those at T0(P > 0.05). SBP, DBP and HR in laryngeal mask group B at T1 time were significantly higher than those in laryngeal mask group A and tracheal intubation group(P<0.05). SBP, DBP and HR in tracheal intubation group at T2 time were significantly higher than those in laryngeal mask group A and laryngeal mask group B, and those in laryngeal mask group B were higher than those in laryngeal mask group A(P<0.05). SBP, DBP and HR in tracheal intubation group at T3 time were significantly higher than those in laryngeal mask group A(P<0.05). The total incidence of adverse reactions during recovery and after operation in laryngeal mask A group was significantly lower than that in laryngeal mask B group and tracheal intubation group, and the operation time and waking time in laryngeal mask A group and laryngeal mask B group were significantly shorter than those in tracheal intubation group(P<0.05).Conclusions The effect of laryngeal mask combined with pentylethylquinone hydrochloride on blood pressure and heart rate in general anesthesia of children is less, and the operation time and awake time are shorter than those of tracheal intubation.