CAJ | 학술논문

目的评价低套囊压力下ProSeal和Supreme喉罩用于腹腔镜手术患者气道管理的效果.方法择期仰卧位腹腔镜手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄20～70岁,体重50～80 kg,随机分为ProSeal喉罩组(P组)和Supreme喉罩组(S组),每组30例.喉罩置入成功后,用手持测压计监测套囊充气压力并维持其为35 cm H2O,记录气道密闭压及气腹前后机械通气时气道压峰值和平均气道压,记录术后并发症的发生情况.结果两组气腹后机械通气时气道压峰值高于气腹前(P＜0.05),两组间比较差异无统计学意义(P＞0.05);术中气腹前后均无漏气现象发生;两组气道密闭压比较差异无统计学意义(P＞0.05);两组拔除喉罩后表面带有血丝及术后咽痛发生率比较差异无统计学意义(P＞0.05).结论低套囊压力(35 cm H2O)下ProSeal和Supreme喉罩通气效果均较好,可安全地用于腹腔镜手术患者的气道管理.
목적 평개저투낭압력하ProSeal화Supreme후조용우복강경수술환자기도관리적효과.방법 택기앙와위복강경수술환자60례,ASA분급Ⅰ혹Ⅱ급,년령20～70세,체중50～80 kg,수궤분위ProSeal후조조(P조)화Supreme후조조(S조),매조30례.후조치입성공후,용수지측압계감측투낭충기압력병유지기위35 cm H2O,기록기도밀폐압급기복전후궤계통기시기도압봉치화평균기도압,기록술후병발증적발생정황.결과 량조기복후궤계통기시기도압봉치고우기복전(P＜0.05),량조간비교차이무통계학의의(P＞0.05);술중기복전후균무루기현상발생;량조기도밀폐압비교차이무통계학의의(P＞0.05);량조발제후조후표면대유혈사급술후인통발생솔비교차이무통계학의의(P＞0.05).결론저투낭압력(35 cm H2O)하ProSeal화Supreme후조통기효과균교호,가안전지용우복강경수술환자적기도관리.
Objective To assess the efficacy of laryngeal mask airway Proseal (LMA Proseal) and Supreme (LMA Supreme) used in patients undergoing laparoscopic surgery when the cuff-pressure was 35 cm H2O.Methods Sixty ASA Ⅰ or Ⅱ patients, aged 20-70 yr, weighing 50-80 kg, undergoing elective laparoscopic surgery, were randomized into2 groups (n = 30 each): LMA ProSeal group (group P) and LMA Supreme group (group S). After the LMA Proseal and LMA Supreme were inserted in group P and S respectively, the cuff pressure was monitored and maintained at 35 cm H2O by manipulate manometer. The airway sealing pressure, peak and mean airway pressure before and after pneumoperitoneum during mechanical ventilation and the complications were also recorded. Results The peak airway pressure was significantly higher after pneumoperitoneum than before pneumoperitoneum during mechanical ventilation (P ＜ 0.05), but there was no significant difference in the peak airway pressure before and after pneumoperitoneum between the two groups ( P ＞ 0.05). The air leakage had never happened before or after pneumoperitoneum during mechanical ventilation. There was no significant difference in the airway sealing pressure between the two groups ( P ＞ 0.05). There was no significant difference in the incidence of throat pain between the two groups(P＞0.05).Conclusion When the cuff pressure is 35 cm H2O, the LMA ProSeal and Supreme can provide adequate ventilation during operation with fewer complications and can be used safely for laparoscopic surgery.