CAJ | 학술논문

目的探讨第四代喉罩用于神经外科侧卧位手术中的安全性和有效性.方法选择神经外科侧卧位手术患者80例,随机分为喉罩组(L组,40例)和气管插管组(E组,40例).记录基础值(T1)、插管前即刻(T2)、插管后即刻(T3)、插管后3 min(T4)、拔管前即刻(T5)和拔管后即刻(T6)和拔管后3 min (T7)的HR、MAP及SpO2变化.观察两组麻醉效果和术后并发症情况.结果与T1时比较,T2～T4时L组MAP和T2、T4时T组MAP明显降低(P＜0.05).与E组比较,L组T3、T4、T5、T6时HR明显减慢、MAP明显降低(P＜0.05).拔管期E组呛咳发生率明显高于L组(P＜0.05),术后咽喉痛、声音嘶哑两组比较差异无统计学意义(P＞0.05)；两组均未发生误吸.结论第四代喉罩可安全应用于侧卧位神经外科手术,可达到和气管插管一样满意的通气效果,且插管与拔管期间对心血管的影响更小,拔管期呛咳发生率减少.
목적 탐토제사대후조용우신경외과측와위수술중적안전성화유효성.방법 선택신경외과측와위수술환자80례,수궤분위후조조(L조,40례)화기관삽관조(E조,40례).기록기출치(T1)、삽관전즉각(T2)、삽관후즉각(T3)、삽관후3 min(T4)、발관전즉각(T5)화발관후즉각(T6)화발관후3 min (T7)적HR、MAP급SpO2변화.관찰량조마취효과화술후병발증정황.결과 여T1시비교,T2～T4시L조MAP화T2、T4시T조MAP명현강저(P＜0.05).여E조비교,L조T3、T4、T5、T6시HR명현감만、MAP명현강저(P＜0.05).발관기E조창해발생솔명현고우L조(P＜0.05),술후인후통、성음시아량조비교차이무통계학의의(P＞0.05)；량조균미발생오흡.결론 제사대후조가안전응용우측와위신경외과수술,가체도화기관삽관일양만의적통기효과,차삽관여발관기간대심혈관적영향경소,발관기창해발생솔감소.
Objective To observe the safety and efficacy of the fourth generation of laryngeal mask airway in lateral position neurosurgical procedure.Methods 80 ASA Ⅱ or Ⅱ patients aged 18-55 undergoing neurosurgical procedure in lateral position were randomly divided into group L (receiving LMA) and group E (receiving endotracheal tube) for airway management.HR,MAP and SpO2 were recorded before intubation (base values,T1),immediately before intubation (T2),immediately after intubation (T3),3 min after intubation (T4),immediately before extubation (T5),immediately after extubation (T6) and 3 min after extubation (T7).Anesthesia effect and postoperation complications were recorded.Results Compared with T1,MAP at T2-T4 in group L and MAP at T2,T4 in group E decreased significantly (P ＜ 0.05).Compared with group E,HR at T3-T6 in group L slowed,MAP at T3-T6 decreased (P ＜ 0.05).Group E had a higher coughing incidence before extubation (P ＜ 0.05).There were no significant differences in the incidences of sore throat and hoarse between two groups.No aspiration occurred.Conclusions The fourth generation of laryngeal mask airway intubation can provide the same safe and effective ventilation as endotracheal intubation in lateral position neurosurgical procedure.Furthermore,it is superior to endotracheal intubation in insection response and coughing response.