SLIPA喉罩麻醉在经腹腹膜前疝修补术中的应用效果

Application effect of SLIPA laryngeal mask airway anesthesia in transabdominal preperitoneal prosthesis

目的探讨SLIPA喉罩麻醉在经腹腹膜前疝修补术(TAPP)中的应用效果。方法选取2017年4月~2018年12月我院收治的126例腹股沟斜疝患者作为研究对象,按照随机数字表法将其分为气管插管组(TI组,n=63)及喉罩组(LM组,n=63)。TI组患者采用气管插管全麻,LM组患者采用SLIPA喉罩全麻。比较两组患者的术中气道压力峰值(Ppeak)、气道压力均值(Pmean)、术中不同时间点的收缩压(SBP)、心率(HR)、血氧分压(PO2)及二氧化碳分压(PCO2)水平,比较两组患者的术后插管相关并发症发生情况。结果LM组患者术中的Ppeak和Pmean均低于TI组,差异有统计学意义(P<0.05)。插管前(T1)及术中(T3),两组患者的SBP及HR比较,差异无统计学意义(P>0.05);插管后(T2)及拔管后(T4),LM组患者的SBP及HR低于TI组,差异有统计学意义(P<0.05);TI组患者T2、T4时间点的SBP及HR高于T1时间点,差异有统计学意义(P<0.05);两组患者T1、T2、T3、T4时间点的PO2及PCO2比较,差异无统计学意义(P>0.05)。LM组患者的术后插管相关并发症总发生率低于TI组,差异有统计学意义(P<0.05)。结论SLIPA喉罩麻醉在满足TAPP术中麻醉需要的同时,还能够减轻患者的呼吸道刺激症状,具有较好的临床效果。

Objective To explore the application effect of SLIPA laryngeal mask airway anesthesia in transabdominal preperitoneal prosthesis(TAPP).Methods A total of 126 cases of patients who was admitted with indirect inguinal hernia in our hospital from April 2017 to December 2018 were selected as research objects,and were divided into tracheal intubation group(TI group,n=63)and laryngeal mask group(LM group,n=63)according to the random number table method.Patients in TI group received general anesthesia with tracheal intubation,while patients in LM group received general anesthesia with SLIPA laryngeal mask airway.The peak airway pressure(Ppeak),mean airway pressure(Pmean),systolic blood pressure(SBP),heart rate(HR),partial pressure of oxygen(PO2)and partial pressure of carbon dioxide(PCO2)at different time points during operation were compared between the two groups,and the incidence of intubation-related complications after operation was compared between the two groups.Results The intraoperative Ppeak and Pmean of patients in LM group were lower than those in TI group,the differences were significative in statistics(P<0.05).There were no significant difference in SBP and HR between the two groups before intubation(T1)and during operation(T3)(P>0.05).The SBP and HR of LM group after intubation(T2)and extubation(T4)were lower than those of TI group,the differences were statistically significant(P<0.05).The SBP and HR of patients in TI group at T2 and T4 time points were higher than those at T1 time points,and the differences were statistically significant(P<0.05).There were no significant difference in PO2 and PCO2 between the two groups at T1,T2,T3 and T4(P>0.05).The total incidence of intubation-related complications in LM group was lower than that in TI group,and the difference was statistically significant(P<0.05).Conclusion SLIPA laryngeal mask airway anesthesia can not only meet the anesthesia needs during TAPP,but also reduce the respiratory tract irritation symptoms of patients,with good clinical effects.