CAJ | 학술논문

目的探讨SLIPA通气道用于剖宫产手术全麻的安全性和可行性.方法足月单胎妊娠行剖宫产手术产妇50例,随机分为SLIPA组(S组)和气管插管组(T组),每组各25例.观察插管前后、拔管前后各时间点的平均动脉压(MAP)、心率、呼气末二氧化碳分压(P_(ET)CO_2)、气道峰压(Paw)的变化;观察插管或置入SLIPA通气道时、拔除前后及术中是否出现呛咳、体动、反流、呕吐、误吸等情况.分别在两组产妇胎儿娩出时抽取脐动、静脉血,进行血气分析.记录两组麻醉诱导至胎儿娩出时间(I-D)、手术时间、新生儿1 min和5 min Apgar评分.结果 S组首次置管成功率为100%,T组有2例再次插管后成功.术中S组有3例出现轻度漏气,不影响呼吸管理.S组心率、MAP比较平稳,插管后2min和拔管后2min与T组比较差异均有统计学意义(P<0.05).两组产妇术中均未发生体动、呛咳、呕吐、反流、误吸;但拔管时,T组有17例发生呛咳、体动,术后2、24 h咽痛发生例数T组分别为10例和6例,而S组均无拔管反应和术后咽痛,两组比较差异均有统计学意义(P<0.05).两组I-D、新生儿1 min和5 min Apgar评分比较,差异均无统计学意义(P>0.05).两组新生儿脐动、静脉血pH值、CO2分压、氧分压比较,差异均无统计学意义(P>0.05.结论 SLIPA通气道较气管插管对母婴生理功能影响小,术后并发症少,可安全用于剖宫产手术麻醉.
목적 탐토SLIPA통기도용우부궁산수술전마적안전성화가행성.방법 족월단태임신행부궁산수술산부50례,수궤분위SLIPA조(S조)화기관삽관조(T조),매조각25례.관찰삽관전후、발관전후각시간점적평균동맥압(MAP)、심솔、호기말이양화탄분압(P_(ET)CO_2)、기도봉압(Paw)적변화;관찰삽관혹치입SLIPA통기도시、발제전후급술중시부출현창해、체동、반류、구토、오흡등정황.분별재량조산부태인면출시추취제동、정맥혈,진행혈기분석.기록량조마취유도지태인면출시간(I-D)、수술시간、신생인1 min화5 min Apgar평분.결과 S조수차치관성공솔위100%,T조유2례재차삽관후성공.술중S조유3례출현경도루기,불영향호흡관리.S조심솔、MAP비교평은,삽관후2min화발관후2min여T조비교차이균유통계학의의(P<0.05).량조산부술중균미발생체동、창해、구토、반류、오흡;단발관시,T조유17례발생창해、체동,술후2、24 h인통발생례수T조분별위10례화6례,이S조균무발관반응화술후인통,량조비교차이균유통계학의의(P<0.05).량조I-D、신생인1 min화5 min Apgar평분비교,차이균무통계학의의(P>0.05).량조신생인제동、정맥혈pH치、CO2분압、양분압비교,차이균무통계학의의(P>0.05.결론 SLIPA통기도교기관삽관대모영생리공능영향소,술후병발증소,가안전용우부궁산수술마취.
Objective To observe the safety and efficacy of the SLIPA mask airway in the cesarean section operation under general anesthesia.Methods Fifty single birth pregnant women who underwent cesarean operation under general anesthesia were randomized into 2 groups.SLIPA mask group(group S,25 cases)and endotracheal intubation(ETT)group(group T,25 cases).Mean arterial pressure(MAP),heart rate(HR),partial pressure of carbon dioxide in end expired gas(P_(ET)CO_2),peak airway pressure(Paw)were measured before induction of anesthesia,just before intubation,2min after intubation,just before extubation,2 min after extubation.Bucking,style,reflow,vomiting,aspiration were observed at inmbation or SLIPA mask airway insertion,before and after extubation and intraoperative.Umbilical arteries and veins blood were collected at delivery for the blood gas analysis.All delivery times,operation time and Apgar scores at 1,5 min were recorded.Results The successful rate ofthe first time intubation was 100% in group S,there was 2 cases by the second time intubation in group T.There Was 3 cases with gently air leak,but no influence on respiratory management.After intubation and extubation,MAP and HR increased significantly in group T (P<0.05),while group S had no significant change.There was no occurrence of bucking,style,reflow,vomiting,aspiration intmoperative,but 17 cages occurred at extubation in group T.The incidence and degree of sore throat in group T(10 cases after 2 hours and 6 cases after 24 hours) were significantly higher than those in group S(P<0.05).The Apgar scores at 1,5 min and delivery times were not significant between the two groups(P>0.05).Conclusion There is less adverse effects of SLIPA mask airway than ETT under general anesthesia in the cesarean section operation,SLIPA mask airway is safe and efficacious.