CAJ | 학술논문

目的：探讨喉罩通气用于全身麻醉(全麻)小儿扁桃体摘除术的安全性与效果。方法60例ASAⅠ~Ⅱ级在全麻下接受扁桃体摘除术的患儿,随机分为喉罩组(A组)和气管插管组(B组),每组30例。观察两组患儿麻醉诱导前(T0)、插入喉罩/气管导管后即刻(T1)、插入喉罩/气管导管后5min(T2)、插入喉罩/气管导管后10min(T3)和拔出喉罩/气管导管后即刻(T4)的SBP、DBP、HR及T2、T3时点的吸气峰压(PIP)和平均气道压(Pmean),记录术后拔管(喉罩)时间、复苏时间,拔管(喉罩)后气道痉挛、胃胀气、声嘶和低SpO2等并发症的发生率。结果B组T1、T4时点SBP、DBP、HR较A组及T0时点显著升高(P<0.05)；T2、T3时点B组PIP和Pmean均高于A组(P<0.05)。B组拔管时间、复苏时间明显长于A组(P<0.05)；拔管后气道痉挛、声嘶的发生率明显高于A组,B组胃胀气的发生率低于A组。结论喉罩通气用于全麻小儿扁桃体摘除术具有良好的安全性,且易于维持血流动力学及呼吸动力学稳定,全麻后恢复平稳。
목적：탐토후조통기용우전신마취(전마)소인편도체적제술적안전성여효과。방법60례ASAⅠ~Ⅱ급재전마하접수편도체적제술적환인,수궤분위후조조(A조)화기관삽관조(B조),매조30례。관찰량조환인마취유도전(T0)、삽입후조/기관도관후즉각(T1)、삽입후조/기관도관후5min(T2)、삽입후조/기관도관후10min(T3)화발출후조/기관도관후즉각(T4)적SBP、DBP、HR급T2、T3시점적흡기봉압(PIP)화평균기도압(Pmean),기록술후발관(후조)시간、복소시간,발관(후조)후기도경련、위창기、성시화저SpO2등병발증적발생솔。결과B조T1、T4시점SBP、DBP、HR교A조급T0시점현저승고(P<0.05)；T2、T3시점B조PIP화Pmean균고우A조(P<0.05)。B조발관시간、복소시간명현장우A조(P<0.05)；발관후기도경련、성시적발생솔명현고우A조,B조위창기적발생솔저우A조。결론후조통기용우전마소인편도체적제술구유량호적안전성,차역우유지혈류동역학급호흡동역학은정,전마후회복평은。
Objective To investigate the safety and efficacy of laryngeal mask airway (LMA) general anesthesia in children tonsillectomy. Methods A total of 60 patients of ASAⅠ~Ⅱstage accepting tonsillectomy under general anesthesia were randomly divided into LMA (group A) and tracheal intubation group (group B), and each group contained 30 cases. Patients were observed before the induction of anesthesia (T0), immediately after inserting the LMA/endotracheal tube (T1), 5 min after LMA/endotracheal tube insertion(T2), 10 min after the LMA/endotracheal tube insertion (T3) and immediately after (T4) LMA/endotracheal tube patients’SBP, DBP, HR, peak inspiratory pressure (PIP) and mean airway pressure (Pmean) at T2, T3 were viewed. The extubation (LMA) time, recovery time, extubation (LMA) after airway spasm, the incidence of bloating, hoarseness and low SpO2 other complications were recorded. Results Group B T1, T4 point SBP, DBP, HR, compared with group A, was significantly higher than T0 (P<0.05);T2, T3 and Pmean point group B PIP were higher than group A (P<0.05). The extubation time and recovery time of group B were longer than those of group A (P<0.05), the after extubation airway spasm, the incidence of hoarseness were significantly higher than group A, and bloating incidence was lower than the group A. Conclusion Laryngeal mask airway anesthesia for pediatric tonsillectomy has good safety, and is easy to maintain stable hemodynamic, respiratory dynamics and steady recovery after general anesthesia.