CAJ | 학술논문

目的：比较I-gel喉罩与Supreme喉罩在全身麻醉甲状腺手术中的气道管理效果。方法全身麻醉下择期行甲状腺手术患者100例，ASAⅠ-Ⅱ级，随机分为I-gel喉罩组（I组，n＝50）与Supreme喉罩组（S组，n＝50）。记录喉罩置入前、后1、3、5min的血流动力学变化及喉罩置入后（T0）、手术开始时（T1）、术中牵拉甲状腺（ T2）、及肿瘤切除后（ T3）各时点的脉搏、氧饱和度（ SPO2）、气道峰压（ Ppeak ）及口咽漏气情况的变化。记录喉罩气道密封压及纤支镜检查评级。记录术毕拔除喉罩的不良反应。结果两组患者各时点血流动力学、SPO2无差异（P＞0．05）。与I组相比，T2时点S组Ppeak明显增高（P＜0．05）；口咽部漏气患者增多（P＜0．05）。 I组喉罩气道密封压[（28±3）cm H2O]明显高于S组[（24±4）cmH2O]（P＜0．05），纤支镜检查评级I组优于S组（ P＜0．05）。结论 I-gel喉罩通气效果好，术中气道密封性更高，可安全有效的应用于全身麻醉甲状腺手术的气道管理。
목적：비교I-gel후조여Supreme후조재전신마취갑상선수술중적기도관리효과。방법전신마취하택기행갑상선수술환자100례，ASAⅠ-Ⅱ급，수궤분위I-gel후조조（I조，n＝50）여Supreme후조조（S조，n＝50）。기록후조치입전、후1、3、5min적혈류동역학변화급후조치입후（T0）、수술개시시（T1）、술중견랍갑상선（ T2）、급종류절제후（ T3）각시점적맥박、양포화도（ SPO2）、기도봉압（ Ppeak ）급구인루기정황적변화。기록후조기도밀봉압급섬지경검사평급。기록술필발제후조적불량반응。결과량조환자각시점혈류동역학、SPO2무차이（P＞0．05）。여I조상비，T2시점S조Ppeak명현증고（P＜0．05）；구인부루기환자증다（P＜0．05）。 I조후조기도밀봉압[（28±3）cm H2O]명현고우S조[（24±4）cmH2O]（P＜0．05），섬지경검사평급I조우우S조（ P＜0．05）。결론 I-gel후조통기효과호，술중기도밀봉성경고，가안전유효적응용우전신마취갑상선수술적기도관리。
Objective To compare the effects of the I-gel Laryngeal mask with the Supreme Laryngeal mask on airway management of patients during thyroid surgery under general anesthesia .Methods 100 patients with ASAⅠ-Ⅱundergoing selective thyroid surgery under general anesthesia were identified and randomized to I -gel ( Group I, n=50) and Supreme (Group S,n=50) group.The hemodynamic changes were recorded at the time before insertion and 1、3、5min after insertion The MAP and HR .The SPO2 ,Ppeak and Oropharyngeal leakage were recorded after la-ryngeal mask insertion ( T0 )、at the beginning of operation ( T1 )、at the time of intraoperative traction of the thyroid ( T2 ) and after resection of the thyroid gland ( T3 ) .We also recorded the airway sealing pressure and rating of fiber endoscopy ,as well as adverse reactions after the removal of Laryngeal mask .Results There were no significant differ-ences in WAP,HR and SPO2 between the two groups.At the time of T2,the Ppeak were higher,and more patients with oropharyngeal leakage were in groupS than that in group I (P<0.05).The airway sealing pressure in group I (28 ± 3cmH2O) was higher than that in group S(24 ±4cmH2O)(P<0.05),and the rating of fiber endoscopy was better in group I than group S(P<0.05).Conclusion The I-gel laryngeal mask airway works well ,with higher airway sealing pressure ,which is safe and effective when used in airway management during the thyroid operation under general anes -thesia.