CAJ | 학술논문

目的研究Supreme喉罩在妇科腹腔镜手术中的安全性、有效性以及不良反应的发生情况.方法回顾2009年10月至2010年4月在北京大学第一医院行妇科腹腔镜手术全身麻醉患者125例,使用喉罩(S组)69例和使用气管插管(T组)56例.记录患者插管(罩)和拔管(罩)前后的心率(HR)和血压(MAP)的变化,记录插管(罩)后和气腹后气道峰压(Ppeak)和呼气末二氧化碳分压(PETCO2)的变化.记录患者围术期不良反应的发生情况.结果与基础值相比,T组HR和MAP在插管即刻和拔管期间均升高(P＜0.05).与T组比较,S组在插管即刻和拔管即刻的HR和MAP明显降低(P＜0.01).两组患者Ppeak和PET.CO2随麻醉和气腹的影响一致,组间比较各时间点差异无统计学意义(P＞0.05).插管(罩)期两组均无体动和呛咳出现,拔管(罩)期S组体动、呛咳和咽痛等不良反应发生率明显少于T组(P＜0.05).结论妇科腹腔镜手术中Supreme喉罩可以达到与气管插管相同的安全有效的通气效果,并且对血流动力学影响小,不良反应少.
목적 연구Supreme후조재부과복강경수술중적안전성、유효성이급불량반응적발생정황.방법 회고2009년10월지2010년4월재북경대학제일의원행부과복강경수술전신마취환자125례,사용후조(S조)69례화사용기관삽관(T조)56례.기록환자삽관(조)화발관(조)전후적심솔(HR)화혈압(MAP)적변화,기록삽관(조)후화기복후기도봉압(Ppeak)화호기말이양화탄분압(PETCO2)적변화.기록환자위술기불량반응적발생정황.결과 여기출치상비,T조HR화MAP재삽관즉각화발관기간균승고(P＜0.05).여T조비교,S조재삽관즉각화발관즉각적HR화MAP명현강저(P＜0.01).량조환자Ppeak화PET.CO2수마취화기복적영향일치,조간비교각시간점차이무통계학의의(P＞0.05).삽관(조)기량조균무체동화창해출현,발관(조)기S조체동、창해화인통등불량반응발생솔명현소우T조(P＜0.05).결론 부과복강경수술중Supreme후조가이체도여기관삽관상동적안전유효적통기효과,병차대혈류동역학영향소,불량반응소.
Objective To explore the safety, efficacy and side effect of Supreme laryngeal mask airway (LMA) used in gynecological laparoscopy. Methods From Oct 2009 to Apr. 2010 in First Hospital of Peking University, 125 patients undergoing general anesthesia for elective gynecological laparoscopy were reviewed, 69 of which were dealt with Supreme LMA (S) and 56 with endotracheal tube (T). After anesthesia induction, changes of HR and MAP were observed during intubation and extubation.The peak inspiratory airway pressure ( Ppeak ) and PETCO2 were monitored. Relevant perioperative side effects were recorded. Results HR and MAP in group T were increased right after intubation and during extubation (P ＜ 0. 05 ), which were significantly decreased in group S (P ＜ 0. 01 ). Ppeak and PETCO2 were comparable in the two groups at all the time points ( P ＞ 0. 05 ). There was no body movement or coughing at the time of intubation. Group S had less incidence of body movement, coughing and sore throat than group T during extubation (P ＜ 0. 05). Conclusion Supreme LMA can provide the same safe and effective ventilation as intubation and less stress response and side effects in gynecological laparoscopy.