新型免充气喉罩GMA在妇科腹腔镜手术中应用的初步评价

The Preliminary Clincal Evaluation of A New Type of Non-Inflatable Laryngeal Mask Airway GMA During Gynecolarpaloscopic Surgery

目的:初步评估免充气型喉罩GMA在妇科腹腔镜术中的应用价值。方法:选择2018年9月~2019年1月择期行妇科腹腔镜手术患者60例为观察对象,在使用包含肌松剂全麻诱导后,插入4号GMA喉罩,评价喉罩和胃管插入的简便性、成功率、口咽漏气压力、纤维支气管镜的喉口构造影像,以及围术期可能的并发症等。结果:GMA喉罩插入简便性令人满意,一次成功率96.7%,气腹前后口咽漏气压分别为29.2mmHg和30.3mmHg,纤维支气管镜喉口结构影像高级别为100%,围术期并发症发生率低且程度轻微。但胃管插入成功率仅53.3%。结论:免充气型喉罩GMA使用方便,口咽漏气压力高,与喉口解剖对应好,可满足妇科腹腔镜手术麻醉通气管理的需要,并可提高患者术后舒适性。建议改进胃管通道的设计以提高胃管插入成功率。

Objevtive: To evaluate the application value of a new type of non-inflatable laryngeal mask airway, the GMA airway, in gynecolarpaloscopic surgery. Mothods: Sixty Adult female scheduled to perform gynecolarpaloscopic surgery in our hospital from september 2018 to January 2019 were selected as objects of observation. After general anesthesia induction which included the uses of mulscle relaxants, the size of number 4 of the GMA airway was intubated, evaluation included ease and success rate of insertion of laryngeal mask placement and the gastric tube, score of fiberoptic bronchoscope (FOB) view before and after pneumoperitoneum, the laryngeal mask airway related complications during the perioperative period. Results: The simplixity of GMA airway insertion is satisfied, with 96.7% first attempted success rate, the oropharygeal leakage pressure is 29.2 mmHg and 30.3mmHg respectively before and after pneumoperitoneum, up to 100% of hight gade view of the glottic structure by the fiberoptic bronchoscopy was obtained, the related perioperative complication is low and mild. However, the success rate of gastric tube insertion is only 53.3%. Conclusion: The non-inflatable GMA larygeal mask airway can be used to maitain the mechanical ventilation of ansethesia during gynecolarpaloscopic surgery, with the advantage of simplixity of insertion, high oropharygeal leakage pressure, good fit of the glottic structure and more comfortable recovery of the patients. But new design of the GMA gastric canal is recomanded to improve the success rate of gastric tube insertion.