CAJ | 학술논문

急诊或择期拟行气管异物取出术患者31例,ASA Ⅰ或Ⅱ级,年龄4～68岁.体重10～79 kg.快速诱导全身麻醉下插入三通喉罩,三通喉罩的标准端口连接麻醉机或呼吸机,行机械通气.静脉输注异丙酚、维库溴铵及瑞芬太尼维持麻醉.于麻醉前5 min(T0)、插入三通喉罩通气即刻、3、5、10、15 min(T1-5)和术毕(T6)时记录SP、DP、HR和spO2,T1～6时记录VT、气道峰压(Ppeak)和PET CO2,T0,2～6时采集桡动脉血样行血气分析.从三通喉罩另一带有密封帽端口置入纤维支气管镜或带取物钳的窥镜,经声门进入气管行异物取出术.手术时间6～34 min,通气时间19～45 min;T1～6时SP、DP、HR、VT、Ppeak和PETCO2与T0时无差异,T2～6时SpO2明显升高;血气分析结果显示:三通喉罩通气后PCO2、PO2和O2sat明显改善;均于术后30 min内清醒并拔除喉罩;无误吸,无明显胃肠充气,无咽喉部水肿及损伤,1例患者苏醒期出现短时轻度躁动;术后均未见明显并发症.
급진혹택기의행기관이물취출술환자31례,ASA Ⅰ혹Ⅱ급,년령4～68세.체중10～79 kg.쾌속유도전신마취하삽입삼통후조,삼통후조적표준단구련접마취궤혹호흡궤,행궤계통기.정맥수주이병분、유고추안급서분태니유지마취.우마취전5 min(T0)、삽입삼통후조통기즉각、3、5、10、15 min(T1-5)화술필(T6)시기록SP、DP、HR화spO2,T1～6시기록VT、기도봉압(Ppeak)화PET CO2,T0,2～6시채집뇨동맥혈양행혈기분석.종삼통후조령일대유밀봉모단구치입섬유지기관경혹대취물겸적규경,경성문진입기관행이물취출술.수술시간6～34 min,통기시간19～45 min;T1～6시SP、DP、HR、VT、Ppeak화PETCO2여T0시무차이,T2～6시SpO2명현승고;혈기분석결과현시:삼통후조통기후PCO2、PO2화O2sat명현개선;균우술후30 min내청성병발제후조;무오흡,무명현위장충기,무인후부수종급손상,1례환자소성기출현단시경도조동;술후균미견명현병발증.
Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.