CAJ | 학술논문

目的：通过观察Supreme喉罩在腹腔镜胆囊切除术中的应用，探讨其安全性与优越性。方法：择期腹腔镜胆囊切除手术患者60例，ASAⅠ～Ⅱ级，随机均分为喉罩组（S组）和气管插管组（T组）。记录诱导前(T0)﹑插入喉罩/气管导管即刻(T1)﹑插入喉罩/气管导管3min(T2)和拔出喉罩/气管导管前3min(T3)﹑拔出喉罩/气管导管即刻(T4)﹑拔出喉罩/气管导管后3min(T5)的MAP、HR、SpO2、PETCO2；丙泊酚用量﹑苏醒和拔罩/管时间，以及术中胃胀气、反流误吸、术后咽喉部不适等并发症。结果：与T组比较，S组患者在麻醉诱导和苏醒阶段（T1～T4）的HR减慢，MAP降低，血流动力学更加平稳（P<0.05）。S组丙泊酚用量降低，苏醒时间、拔喉罩时间缩短(P<0.05)。S组有2例患者术中气道阻力升高，PETCO2升高至60mmHg。术后咽喉不适S组（2例）明显少于T组（10例）(P<0.05)。结论：与气管插管比较，Supreme喉罩对血流动力学影响小，麻醉用药量减少，苏醒快且并发症少，是一种较为理想的全麻气道管理工具，但术中应监测PETCO2。
목적：통과관찰Supreme후조재복강경담낭절제술중적응용，탐토기안전성여우월성。방법：택기복강경담낭절제수술환자60례，ASAⅠ～Ⅱ급，수궤균분위후조조（S조）화기관삽관조（T조）。기록유도전(T0)﹑삽입후조/기관도관즉각(T1)﹑삽입후조/기관도관3min(T2)화발출후조/기관도관전3min(T3)﹑발출후조/기관도관즉각(T4)﹑발출후조/기관도관후3min(T5)적MAP、HR、SpO2、PETCO2；병박분용량﹑소성화발조/관시간，이급술중위창기、반류오흡、술후인후부불괄등병발증。결과：여T조비교，S조환자재마취유도화소성계단（T1～T4）적HR감만，MAP강저，혈류동역학경가평은（P<0.05）。S조병박분용량강저，소성시간、발후조시간축단(P<0.05)。S조유2례환자술중기도조력승고，PETCO2승고지60mmHg。술후인후불괄S조（2례）명현소우T조（10례）(P<0.05)。결론：여기관삽관비교，Supreme후조대혈류동역학영향소，마취용약량감소，소성쾌차병발증소，시일충교위이상적전마기도관리공구，단술중응감측PETCO2。
Objective:To observe the application of supreme laryngeal mask airway in laparoscopic cholecystec-tomy, and explore its security and advantages. Methods:60 patients with elective laparoscopic cholecystectomy surgery, ASAⅠ~Ⅱlevel, were randomly divided into two groups, laryngeal mask group (group S) and trachea intubation group(group T). MAP, HR, SpO2 and PETCO2 will be recorded before the induction(T0), at intubating LMA/tube instant-ly(T1), 3 min after intubating (T2) and 3 min before pulling out LMA/tube (T3), pulling out instantly (T4),3 min after pulling out(T5). Dosage of propofol, the time of waking up and pulling out LMA/tube were be recorded. And complica-tions, such as intraoperative flatulence, reflux and aspiration postoperative, throat discomfort were also recorded. Re-sults:Compared with, HR, MAP in group S were significantly lower at T1~T4, and dosage of propofol in group S were lower. Time of waking up and pulling out LMA in group S were lower than group T(P<0.05). But intraoperative airway pressure and PETCO2 of 2 patients increased to 60 mmHg in group S. Incidence of postoperative throat discomfort in group S (2 cases) was obviously less than group T(10 cases) (P<0.05). Conclusion:Compared with endotracheal intu-bation, supreme LMA is one of ideal airway management tools, because it can make more stable hemodynamics, re-duce dose of propofol and complications during anesthesia, but PETCO2 should be monitored perioperatively.