对比分析喉罩全身麻醉与蛛网膜下腔阻滞在经尿道输尿管镜碎石手术中的效果

Effect of Laryngeal Mask General Anesthesia and Subarachnoid Block in Transurethral Ureteroscopic Lithotripsy

目的探讨在经尿道输尿管镜碎石手术中采取喉罩全身麻醉方式与采取蛛网膜下腔阻滞的临床价值。方法随机选取2020年3月—2022年2月期间在池州市中医医院行经尿道输尿管镜碎石手术的60例患者,随机编号平均分成2组,对照组在手术中为其施以蛛网膜下腔阻滞,研究组在手术中为其施以喉罩全身麻醉,分析麻醉效果,对比麻醉效果、心率与平均动脉压、疼痛评分、围术期指标以及不良反应发生率。结果研究组麻醉优良率高于对照组,差异有统计学意义(χ^(2)=4.320,P<0.05);研究组T1、T2时刻心率与平均动脉压水平均较对照组低,差异有统计学意义(P<0.05);研究组术后6 h、24 h疼痛评分(3.36±1.05)分、(2.12±0.27)分均低于对照组,差异有统计学意义(t=3.491、6.073,P<0.05);研究组麻醉开始到手术开始时间、进食时间、术后排气时间以及住院时间均短于对照组,差异有统计学意义(t=8.362、13.498、14.909、14.144,P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在经尿道输尿管镜碎石手术中采用喉罩全身麻醉方式麻醉效果更佳且舒适度较好,有利于术后恢复,建议推广应用。

Objective To investigate the clinical value of laryngeal mask anesthesia and subarachnoid block in transurethral ureteroscopic lithotripsy.Methods Sixty patients who underwent transurethral ureteroscopic lithotripsy in Chizhou Hospital of Traditional Chinese Medicine from March 2020 to February 2022 were randomly selected and randomly assigned into 2 groups.The control group received subarachnoid block during the operation,and the study group received laryngeal mask general anesthesia.The anesthetic effect was analyzed and compared with the anesthetic effect,heart rate and mean arterial pressure,pain scores,perioperative indicators and the incidence of adverse reactions.Results The excellent and good anesthesia rate in the study group was higher than that in the control group,and the difference was statistically significant(χ^(2)=4.320,P<0.05).The heart rate and mean arterial pressure at T1 and T2 in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The pain scores(3.36±1.05)points and(2.12±0.27)points of the study group at 6 h and 24 h after surgery were lower than those of the control group,,and the difference was statistically significant(t=3.491,6.073,P<0.05).The time from the beginning of anesthesia to the beginning of the operation,feeding time,postoperative exhaust time and hospital stay in the study group were shorter than those of the control group,and the difference was statistically significant(t=8.362,13.498,14.909,14.144,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Laryngeal mask general anesthesia in transurethral ureteroscopic lithotripsy has better anesthetic effect and better comfort,which is conducive to postoperative recovery,so it is recommended to be popularized and applied.