I-gel喉罩在腹腔镜联合胆道镜保胆手术中的应用效果

Application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy

目的探讨I-gel喉罩在腹腔镜联合胆道镜保胆手术中的应用效果。方法选取2016年8月~2018年8月北京市中西医结合医院择期全麻下行腹腔镜联合胆道镜保胆手术的患者64例,Excel随机发生器随机分为I-gel喉罩组(A组)与气管插管组(B组),每组各32例。麻醉诱导后,A组放置喉罩,B组气管插管。比较两组麻醉时间、气腹时间、拔管时间;观察麻醉诱导后(T1)、喉罩置入(或插管)后即刻(T2)、喉罩置入(或插管)后3 min(T3)、喉罩置入(或插管)后10 min(T4)时的心率(HR)、收缩压(SBP)、舒张压(DBP)变化;观察置管时间及拔管前后有无耐管、呛咳、躁动以及咽喉疼痛等不良反应发生情况。结果两组麻醉时间、气腹时间、拔管时间比较,差异无统计学意义(P>0.05);A组各时间点HR、SBP、DBP变化比较,差异均无统计学意义(均P>0.05);B组T2、T3、T4时间点HR、SBP、DBP均高于A组,差异均有统计学意义(均P<0.05),B组T2、T3、T4时间点HR、SBP、DBP均高于T1,差异均有统计学意义(均P<0.05)。A组置管时间及不良反应发生情况均低于B组,差异均有统计学意义(均P<0.05)。结论I-gel喉罩用于全身麻醉下行腹腔镜联合胆道镜保胆手术,比气管插管全麻操作更方便,血流动力学更稳定且并发症少,应用效果安全可靠。

Objective To investigate the application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy.Methods From August 2016 to August 2018,64 cases with laparoscopic combined with choledochoscopic choledochoscopy under general anesthesia in Beijing Hospital of Integrated Traditional Chinese and Western Medicine were selected.According to the Excel randomizer,they were randomly divided into I-gel laryngeal mask group(A group)and endotracheal intubation group(B group),with 32 cases in each group.After anesthesia induction,laryngeal mask was placed in group A and endotracheal intubation was performed in group B.The anesthesia time,pneumoperitoneum time and tube extubation time in two groups were compared.The changes of heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in two groups were observed immediately after anesthesia induction(T1),laryngeal mask placement(or intubation)(T2),laryngeal mask placement(or intubation)3 min(T3),and laryngeal mask placement(or intubation)10 min(T4).Meanwhile,intubation time,degree of tube tolerance,cough,agitation and pharyngeal pain in two groups were observed.Results There were no significant differences in anesthesia time,pneumoperitoneum time and tube extubation time between two groups(P>0.05).There were no significant differences in HR,SBP and DBP at each time point in group A(all P>0.05).HR,SBP and DBP at time points T2,T3 and T4 in group B were all higher than those in group A,and the differences were statistically significant(all P<0.05).In group B,HR,SBP and DBP at time points T2,T3 and T4 were all higher than T1,and the differences were statistically significant(all P<0.05).Conclusion I-gel laryngeal mask is used for laparoscopic combined with choledochoscope cholelithotomy under general anesthesia,which is more convenient than endotracheal intubation,more stable hemodynamics and fewer complications.The application effect is safe and reliable.