喉罩全麻复合硬膜外麻醉在胃肠道手术中的临床应用研究

Clinical application of laryngeal mask general anesthesia combined with epidural anesthesia in gastrointestinal surgery

目的探讨喉罩全身麻醉(全麻)复合硬膜外麻醉应用于胃肠道手术中的临床效果。方法72例行胃肠手术的患者,随机分为气管插管组(35例)和喉罩组(37例)。喉罩组采用喉罩全麻复合硬膜外麻醉,气管插管组采用气管插管全麻复合硬膜外麻醉。比较两组围术期血流动力学指标、不良反应发生情况。结果喉罩组置入喉罩/插管即刻、喉罩/插管置入后5 min、拔管/罩即刻和拔管/罩后5 min心率和平均动脉压水平均低于气管插管组,差异有统计学意义(P<0.05)。喉罩组不良反应发生率为13.51%,低于气管插管组的40.00%,差异有统计学意义(P<0.05)。结论胃肠道手术麻醉师时应用喉罩全麻复合硬膜外麻醉对血流动力学指标影响更小,不良反应风险较低,应用于胃肠道手术的安全性较高,值得推广借鉴。

Objective To discuss the clinical effect of laryngeal mask general anesthesia combined with epidural anesthesia in gastrointestinal surgery.Methods A total of 72 patients who underwent gastrointestinal surgery were randomly divided into tracheal intubation group(35 cases)and laryngeal mask group(37 cases).The laryngeal mask group received laryngeal mask general anesthesia combined with epidural anesthesia,and the tracheal intubation group received tracheal intubation general anesthesia combined with epidural anesthesia.The perioperative hemodynamic indexes and occurrence of adverse reactions were compared between the two groups.Results The heart rate and mean arterial pressure in the laryngeal mask group were lower than those in the tracheal intubation group at the moment of laryngeal mask insertion/immediate intubation,5 min after laryngeal mask/intubation insertion,immediately after extubation/mask and 5 min after extubation/mask,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the laryngeal mask group was 13.51%,which was lower than 40.00%in the tracheal intubation group,and the difference was statistically significant(P<0.05).Conclusion The application of laryngeal mask general anesthesia combined with epidural anesthesia in gastrointestinal surgery has less effect on hemodynamics indexes,and the risk of adverse reactions is low.The application of laryngeal mask general anesthesia in gastrointestinal surgery has higher safety,which is worthy of promotion and reference.