文章摘要
赵东芳,张付军.SLIPA喉罩用于全麻妇科腹腔镜手术气道管理的效果分析[J].中国医药导刊,2017,19(12):1257-1260.
SLIPA喉罩用于全麻妇科腹腔镜手术气道管理的效果分析
Efficacy of SLIPA Laryngeal Mask in Airway Management for Gynecological Laparoscopic Surgeries under General Anesthesia
投稿时间:2017-06-25  修订日期:2017-11-15
DOI:
中文关键词: SLIPA喉罩  全麻  妇科腹腔镜手术  气管插管
英文关键词: SLIPA laryngeal mask  General anesthesia  Gynecological laparoscopic surgery  Endotracheal intubation
基金项目:
作者单位E-mail
赵东芳 北京市平谷区妇幼保健院麻醉科 13661262386@163.com 
张付军 北京市平谷区妇幼保健院麻醉科  
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中文摘要:
      目的:观察SLIPA喉罩用于全麻妇科腹腔镜手术中气道管理的安全性和有效性。方法: 选80例择期妇科腹腔镜手术患者,美国麻醉师协会(ASA)分级Ⅰ~Ⅱ级,随机分SLIPA 喉罩组(S组)、气管插管组(T组)。记录插管时间、首次置管成功率;观察基础值(T0)、插管后1min(T1)、插管后3min(T2)、拔管前即刻(T3)和拔管后1min(T4)各时点的平均动脉压(MAP)、心率(HR) 和血氧饱和度(SpO2),比较两组控制呼吸时气腹前后不同时段的气道峰压(Ppeak)、潮气量(Vt)、呼气末二氧化碳分压(PETCO2) 及插管相关并发症。结果: T组患者T1、T3、T4的MAP和HR比T0和S组各对应时点均明显升高,差异有统计学意义,S组T2时MAP明显低于T0时,差异有统计学意义(P<0.05)。两组患者术中通气均满意,Ppeak、VT、PETCO2组间比较各时点差异无统计学意义(P>0.05)。与气腹前比较,气腹后Ppeak和PETCO2组内比较均高于气腹前,差异有统计学意义(P<0.05)。S组置管时间明显短于T组(P<0.05)。两组首次置管成功率差异无统计学意义。拔管期及术后24h并发症,S组明显低于T组,差异有统计学意义(P<0.05)。结论: SLIPA喉罩用于全麻妇科腹腔镜手术通气效果满意,患者应激反应小,安全可行。
英文摘要:
      Objective:To evaluate the safety and efficacy of SLIPA laryngeal mask in airway management for gynecological laparoscopic surgeries under general anesthesia. Methods: Eighty patients who underwent elective gynecologic laparoscopic surgery with ASA status Ⅰ~Ⅱ were enrolled and randomly divided into SLIPA laryngeal mask group (S group) and endotracheal intubation group (T group). Time for intubation and the success rate at the first attempt were recorded. Measurements of mean arterial pressure(MAP), heart rate (HR) and oxygen saturation (SpO2) at baseline(T0), 1 min (T1) after intubation, 3 min(T2) after intubation, immediately before extubation (T3),and 1 min after extubation (T4) were collected. Airway peak pressure (Ppeak), tidal volume (Vt), End-tidal CO2 partial pressure(PETCO2) were compared between two groups before and after establishing pneumoperitoneum, as well as intubation-related complications. Results: MAP and HR of the T group at points of T1, T3 and T4 were significantly higher than those at T0 as well as those of the S group (P<0.05). MAP of the S group at T2 was significantly lower than T0 (P<0.05).Satisfying controlled ventilation were achieved in both groups and no significant differences in Ppeak, VT and PETCO2 were observed between the two groups (P>0.05). Ppeak and PETCO2 after were significantly higher than those before establishing pneumoperitoneum (P<0.05). Intubation time in the S group was significantly shorter than the T group (P<0.05). There was no significant difference in first-attempt success rate between two groups. There was significant difference between the two groups as in complications during extubation and postoperative 24 h(P<0.05). Conclusion: SLIPA laryngeal mask is safe and feasible for airway management in gynecological laparoscopic surgeries, with satisfying ventilation but less intubation responses.
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