CAJ | 학술논문

目的：探讨欧普乐喉罩在老年患者全麻手术中的应用效果。方法 ASA Ⅱ-Ⅲ级、拟在全麻下实施腹部手术的患者共72例，随机分为气管插管全麻组（ B组，32例）和喉罩全麻组（ H组，40例）。2组均静脉给予丙泊酚1．5 mg· kg-1、芬太尼4μg· kg-1、罗库溴铵0．6 mg· kg-1进行麻醉诱导，B组气管插管，H组置入OPLAC-LMA喉罩，观察2组患者在麻醉诱导前后、插管时、拔管时的心率、脉搏血氧饱和度（ SpO2）、收缩压（ SBP）、舒张压（DBP）和平均动脉压（MAP）的变化，比较气道峰压（Ppeak）、呼气末二氧化碳分压（ETCO2）和术后咽喉疼痛的情况。结果诱导前后，2组患者血压和心率比较差异无统计学意义（P＞0．05）；在插管时、拔管前以及拔管时，血压、心率比较差异有统计学意义（ P＜0．01）。2组均能顺利完成手术，术后B组患者发生咽喉部疼痛12例， H组仅2例患者感咽喉部不适。结论喉罩应用于老年人全麻手术能显著降低心血管反应，安全可靠，并发症少。
목적：탐토구보악후조재노년환자전마수술중적응용효과。방법 ASA Ⅱ-Ⅲ급、의재전마하실시복부수술적환자공72례，수궤분위기관삽관전마조（ B조，32례）화후조전마조（ H조，40례）。2조균정맥급여병박분1．5 mg· kg-1、분태니4μg· kg-1、라고추안0．6 mg· kg-1진행마취유도，B조기관삽관，H조치입OPLAC-LMA후조，관찰2조환자재마취유도전후、삽관시、발관시적심솔、맥박혈양포화도（ SpO2）、수축압（ SBP）、서장압（DBP）화평균동맥압（MAP）적변화，비교기도봉압（Ppeak）、호기말이양화탄분압（ETCO2）화술후인후동통적정황。결과유도전후，2조환자혈압화심솔비교차이무통계학의의（P＞0．05）；재삽관시、발관전이급발관시，혈압、심솔비교차이유통계학의의（ P＜0．01）。2조균능순리완성수술，술후B조환자발생인후부동통12례， H조부2례환자감인후부불괄。결론후조응용우노년인전마수술능현저강저심혈관반응，안전가고，병발증소。
Objective To assess the application of OPLER laryngeal mask in elderly patients undergoing general an -esthesia.Methods Seventy-two ASASⅡ-Ⅲpatients aged 70-83 years (40 men and 32 women) requiring abdomi-nal surgery under general anesthesia were randomly divided into two groups , according to their treatment of tracheal intu-bation (group B, n=32) and laryngeal mask (group H, n=40).All patients were intravenously administrated with 1.5 mg/kg propofol, 4 μg/kg fentanyl, and 0.6 mg/kg rocuronium bromide for anesthesia induction .Then, the heart rate (HR), pulse oxygen saturation (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure ( MAP) were measured before/after anesthesia induction , and when intubation and extubation were per-formed.Also, the airway pressure (Ppeak), end-tidal carbon dioxide (ETCO2) and the number of patients complai-ning postoperative throat pain were recorded .Results No significant differences were found as to blood pressure and heart rate in both groups before and after anesthetic induction (P>0.05).However, significant differences were seen during intubation and before and after extubation (P<0.01).Both groups were able to complete operation , with 12 ca-ses of postoperative throat pain in group B and simply 2 cases of throat discomfort in group H .Conclusion The applica-tion of laryngeal mask in elderly patients for general anesthesia is safe and can significantly reduce the rates of cardiovas -cular adverse reaction , with less complications .