传统喉罩与免充气喉罩在腹腔镜胆囊切除术中的应用研究

Application of laryngeal mask airway and oro-pharyngeal airway cap laryngeal mask on laparoscopic cholecystectomy

目的探讨在腹腔镜手术中使用喉罩的可行性和应注意的相关问题。方法选择择期全麻下行腹腔镜胆囊切除术(LC)病人80例,随机均分为传统喉罩组(L组)和免充气喉罩组(N组)。记录病人入室后的生命体征基础值(T0)、喉罩置入后的平均动脉血压(MAP)及HR,并通过麻醉机记录各时间点两组病人的潮气量VT、气道压峰值(Ppeak)及呼气末二氧化碳(PETCO_2),并记录喉罩一次性置入成功率,术后24h随访病人呼吸道及咽部情况。结果两组病人喉罩一次性置入成功率及术后咽部并发症的发生率差异无统计学意义,气腹后3min和10min呼吸道峰压和呼吸末二氧化碳均较气腹前升高,但仍处于正常范围内。结论传统喉罩和免充气喉罩均可安全有效地用于腹腔镜胆囊切除手术,人工气腹虽然导致气道压力明显上升,但对两种喉罩的通气效果无明显影响。

Objective To investigate the feasibility and safety of the laryngeal mask airway and oro-pharyngeal airway cap laryngeal mask on patients undergoing Laparoscopic cholecystectomy.Methods Eighty ASA Ⅰ or Ⅱ patients scheduled for Laparoscopic cholecystectomy under general anesthesia were alocated randomly to either laryngeal mask group(group L) or OPLAC laryngeal mask group(group N).The patients VT,Ppeak,PETCO2,MAP,HR and SPO_2 were recorded before anaesthesia(TO),after intubation at 1 min(T1),5min(T2),before artificial pneumoperitoneum(T3),after pneumoperitoneum at 3 min(T4),10min(T5).Results The incidence of pharyngeal complications between two group is no difference.The Ppeak and PETCO_2 after artificial pneumoperitoneum 3 min(T4),10min(T5) of two group were all higer than those before pneumoperitoneum(T3).Conclutions The laryngeal mask airway and oro-pharyngeal airway cap laryngeal mask were all stable and safe on patients undergoing Laparoscopic cholecystectomy.