喉罩通气对全麻腹腔镜胆囊切除术患者麻醉效果的影响

Effects of laryngeal mask airway on anesthesia effects of laparoscopic cholecystectomy in general anesthesia

目的探讨喉罩通气对腹腔镜胆囊切除术患者麻醉效果及术后下呼吸道感染的影响。方法160例行全麻腹腔镜胆囊切除术患者随机均分为观察组(喉罩通气)和对照组(气管内插管通气),分别于麻醉前、麻醉诱导时、置入喉罩或气管插管时、手术30 min时及拔除喉罩或气管导管时检测2组患者心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO_(2))水平,收集2组患者围术期的麻醉起效时间、阻滞完全时间、自主呼吸恢复时间、定向力恢复时间、苏醒时间及麻醉并发症的发生情况,同时记录2组患者术后下呼吸道感染的发生。结果对照组患者麻醉诱导时HR和MAP水平均明显低于观察组,置入喉罩或气管插管时、手术30 min时及拔除喉罩或气管导管时明显高于观察组(P<0.05);观察组患者漏气的发生率高于对照组,术中呛咳、苏醒期躁动的发生率低于对照组(P<0.05);观察组患者下呼吸道感染率低于对照组,差异有统计学意义(P<0.05)。结论与气管插管通气相比,应用喉罩通气可更好地维持全麻腹腔镜胆囊切除术中患者的血流动力学指标,且对苏醒时间和术后并发症无不良影响。

Objective To investigate the effects of laryngeal mask airway on the anesthesia effects of laparoscopic cholecystectomy in general anesthesia.Methods One hundred and sixty cases of patients treated with laparoscopic cholecystectomy by general anesthesia were randomly divided into observation group(laryngeal mask airway)and the control group(endotracheal intubation airway).The heart rate(HR),the mean arterial pressure(MAP),and blood oxygen saturation(SpO_(2))levels at the time points of before anesthesia,anesthesia induction,laryngeal mask location or tracheal intubation,30 min of surgery,removal of laryngeal mask or endotracheal tube of both groups were detected.The onset time of anesthesia,the time of completed block,the time of spontaneous breathing recovery,the time of directional ability recovery and anesthesia complications in the perioperative period of both groups were collected.The incidence of post-operation lower respiratory tract infections of both groups was recorded.Results The HR and MAP levels at the time of anesthesia induction in control group were significantly lower than those in observation group.HR and MAP levels at the time of laryngeal mask location or tracheal intubation,30 min of surgery,removal of laryngeal mask or endotracheal tube of control group were significantly higher than those in the observation group(P<0.05).The incidence of air leakage of patients in observation group was higher than those in the control group.The incidence of intraoperative cough,restless during recovery period of the patients in the observation group were lower than those of control group(P<0.05).The incidence of lower respiratory tract infections of patients in observation group were lower than those in control group,differences were statistically significant(P<0.05).Conclusions Compared with the application of endotracheal intubation,the application of laryngeal mask airway can maintain the stability of hemodynamics of patients more efficiently in laparoscopic cholecystectomy in general anesthesia,lower the incidence of post-operative lower respiratory tract infections,and has no adverse effects on the recovery time and the postoperative complications.