CAJ | 학술논문

目的观察可弯曲喉罩(flexible laryngeal mask airway,FLMA)与一次性双管喉罩(supreme laryngeal mask airway,SLMA)在鼻内窥镜手术中的气道管理效果,并对二者进行比较. 方法选取择期行鼻内窥镜手术患者40例.美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级、年龄20岁～70岁、体重指数＜30 kg/m2.按随机数字表法随机分成两组,分别为FLMA组(F组)及SLMA组(S组),每组各20例.记录麻醉时间、手术时间、喉罩拔除时间(术毕至呼吸恢复正常可以拔除喉罩的时间)和苏醒时间(术毕至呼之睁眼的时间)；术毕即刻、术后6、24、36 h咽喉疼痛发生情况；术者满意程度.统计学分析处理采用SPSS 19.0软件完成. 结果 ①两组喉罩首次成功率分别为95％、90％,差异无统计学意义(P＞0.05).②F组置入时间(10.2±1.8)s,S组置入时间(6.3±1.3)s,差异有统计学意义(P＜0.05).③气道压、气道密封压、纤维支气管镜(branchofiberoscope,FOB)检查分级、两组术后拔出喉罩即刻咽喉疼痛发生例数、术后6h咽喉疼痛发生例数差异无统计学意义(P＞0.05).④两组之间手术医生的满意度差异无统计学意义(P＞0.05),但是F组有一个上升的趋势. 结论 ①FLMA与SLMA均可应用于全身麻醉下鼻内窥镜手术的气道管理,安全可靠.SLMA比FLMA更易置入.②FLMA可适用于各类鼻内镜手术,SLMA在涉及到额窦的手术时应用受到一定限制.
목적 관찰가만곡후조(flexible laryngeal mask airway,FLMA)여일차성쌍관후조(supreme laryngeal mask airway,SLMA)재비내규경수술중적기도관리효과,병대이자진행비교. 방법 선취택기행비내규경수술환자40례.미국마취의사협회(ASA)분급Ⅰ～Ⅱ급、년령20세～70세、체중지수＜30 kg/m2.안수궤수자표법수궤분성량조,분별위FLMA조(F조)급SLMA조(S조),매조각20례.기록마취시간、수술시간、후조발제시간(술필지호흡회복정상가이발제후조적시간)화소성시간(술필지호지정안적시간)；술필즉각、술후6、24、36 h인후동통발생정황；술자만의정도.통계학분석처리채용SPSS 19.0연건완성. 결과 ①량조후조수차성공솔분별위95％、90％,차이무통계학의의(P＞0.05).②F조치입시간(10.2±1.8)s,S조치입시간(6.3±1.3)s,차이유통계학의의(P＜0.05).③기도압、기도밀봉압、섬유지기관경(branchofiberoscope,FOB)검사분급、량조술후발출후조즉각인후동통발생례수、술후6h인후동통발생례수차이무통계학의의(P＞0.05).④량조지간수술의생적만의도차이무통계학의의(P＞0.05),단시F조유일개상승적추세. 결론 ①FLMA여SLMA균가응용우전신마취하비내규경수술적기도관리,안전가고.SLMA비FLMA경역치입.②FLMA가괄용우각류비내경수술,SLMA재섭급도액두적수술시응용수도일정한제.
Objective To observe the Efficacy of flexible laryngeal mask airway(FLMA) and supreme laryngeal mask airway (SLMA) in nasal endoscopic surgery.Methods 40 patients aged 20-70 and ASA Ⅰ-H,the patients are randomly divided into two groups,FLMA group (F group) and SLMA group (S group).The rate of LMA successful placement,LMA placement time,fiberoptic bronchoscope grade,airway sealing pressure,airway pressure,air leakage during operation,complication,the length of anesthesia time,duration of surgery,extubation time,emergence time and the satisfication of surgeons was recorded.Results The successful placement at first time was 95％、90％ respectively.The time of placement in S group was shorter than that in F group [(6.3±1.3) s vs (10.2±1.8) s,P＜0.05].The differences of fiberoptic bronchoscope grade,airway sealing pressure,airway pressure,air leakage during operation,complication between two groups have no statistical significance (P＞0.05).There was no statistical significance between two groups in surgeon's satisfaction.Conclusions Both FLMA and SLMA were safe for nasal endoscopic surgery,and the placement of SLMA was much easier.FLMA may be a better choice in nasal endoscopic surgery without frontal sinus.