喉罩麻醉用于下腹部腹腔镜手术中的临床效果及对心脏功能影响

目的:研究喉罩麻醉用于下腹部腹腔镜手术的临床效果和对心脏功能影响;方法:选取2015年1月-2016年1月间我院收治的行下腹部腹腔镜手术患者84例,采用随机数字法将所有患者分为LMA组和TI组,每组各42例,LMA组患者采用喉罩麻醉,TI组患者采用常规气管插管麻醉,比较两组患者的手术时间、麻醉时间、苏醒时间及拔管时间,比较两组患者的不良反应发生情况,同时比较两组患者各时期SpO_2、PETCO_2、气道峰压(Ppeak)、平均动脉压(MAP)及心率变化。结果:与TI组比较,LMA组患者在手术时间和麻醉时间上无明显差异(P>0.05),但拔管时间和苏醒时间显著缩短(P<0.05),拔除喉罩后低氧血症、呛咳、术后烦躁、咽喉痛的发生率降低(P<0.05);各时点Sp0_2、PETCO_2、Ppeak均在正常范围内,组间比较差异无统计学意义(P>0.05)。L组喉罩置入成功率和T组气管插管成功率比较差异无统计学意义(P>0.05),LMA组患者术后平均动脉压以及患者心率均显著低于对照组(P<0.05).结论:喉罩麻醉用于下腹部腹腔镜手术患者中的临床效果明显,能有效降低手术对患者心脏的影响,维持手术过程中的血压稳定,同时加快患者苏醒速度,降低不良反应的发生率,值得临床上推广使用。

Objective:To assess the efficacy of laryngeal mask airway used in patients undergoing lower abdomen laparoscopic surgery.Methods: 82 patients from january 2015 to january 2016 undergoing elective lower abdomen laparoscopic surgery were randomized to 2 groups(n=42each):LMA group(group LMA)and tracheal intubation group(group TI).In group LMA, the LMA was inserted after induction of anesthesia.In group TI,the patients were intubated under Dishiendoscopic.The Sp02,PETC02,Ppeak airway pressure and SBP,DBP,heart rate were record.Compared the two groups in success rate, operation times,anesthesia time,extubation time,and patient recovery time,and the complications were recorded.Results:There was no significant difference in the success rate operation times,anesthesia time between the two groups(P>0.05).But the extubation time and recovery time were significantly shorter in group LMA than in group TI(P<0.05). The rate of hypoxemia,nausea and vomiting,choking hoarseness,postoperative irritation,sore throat and regurgitation of gastric contents occuring is lower in group LMA(P<0.05).The Sp02,PETCO2 and Ppeak pressure were within normal range in both groups(P>0.05),the MAP and Heart Rate of group LMA is obviously lower than the group TI(P<0.05).Conclusion: The efficience of LMA is obvious,can provide adequate ventilation during operation with less complications,shorten the weaking time and can decrease the damage of heart Maintain,the blood preesure in a normal level,can be used effectively for lower abdomen laparoscopic surgery.