CAJ | 학술논문

目的评价I-gel喉罩用于乳腺癌根治术患者气道管理的效果.方法择期拟行全麻乳腺癌根治术患者120例,ASA分级Ⅰ或Ⅱ级,年龄25 ～ 64岁,体重45 ～ 90 kg,体重指数＜30 kg/m2,Mallampati分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组(n=60):I-gel喉罩组(Ⅰ组)和经典喉罩组(C组).麻醉诱导后,I组和C组分别置入I-gel喉罩和经典喉罩,记录喉罩首次置入成功率、喉罩置入时间、喉罩密封压及术中气道峰压,纤维支气管镜检查评估喉罩对位情况,记录术中口咽部漏气、低氧血症和不良反应发生情况.结果两组喉罩置入成功率均为100％;与C组比较,Ⅰ组喉罩首次置入成功率和纤维支气管镜检查评分升高,喉罩置入时间缩短,血迹残留和咽痛发生率降低(P＜0.05);C组有5例患者发生一过性气道压力增高和口咽部漏气情况,经处理后恢复,Ⅰ组则无一例发生;两组均无低氧血症发生.结论 I-gel喉罩较经典喉罩易于置入,且首次置入成功率高,不良反应少,可安全有效地用于乳腺癌根治术患者的气道管理.
목적 평개I-gel후조용우유선암근치술환자기도관리적효과.방법 택기의행전마유선암근치술환자120례,ASA분급Ⅰ혹Ⅱ급,년령25 ～ 64세,체중45 ～ 90 kg,체중지수＜30 kg/m2,Mallampati분급Ⅰ혹Ⅱ급,채용수궤수자표법,장환자수궤분위2조(n=60):I-gel후조조(Ⅰ조)화경전후조조(C조).마취유도후,I조화C조분별치입I-gel후조화경전후조,기록후조수차치입성공솔、후조치입시간、후조밀봉압급술중기도봉압,섬유지기관경검사평고후조대위정황,기록술중구인부루기、저양혈증화불량반응발생정황.결과 량조후조치입성공솔균위100％;여C조비교,Ⅰ조후조수차치입성공솔화섬유지기관경검사평분승고,후조치입시간축단,혈적잔류화인통발생솔강저(P＜0.05);C조유5례환자발생일과성기도압력증고화구인부루기정황,경처리후회복,Ⅰ조칙무일례발생;량조균무저양혈증발생.결론 I-gel후조교경전후조역우치입,차수차치입성공솔고,불량반응소,가안전유효지용우유선암근치술환자적기도관리.
Objective To evaluate the efficacy of I-gel laryngeal mask airway (LMA) for airway management in patients undergoing radical mastectomy.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients (Mallampati Ⅰ or Ⅱ),aged 25-64 yr,weighing 45-90 kg,with body mass index ＜ 30 kg/m2,scheduled for elective radical mastectomy under general anesthesia,were randomized into 2 groups (n=60 each): I-gel LMA group (group Ⅰ) and Classic LMA (group C).Anesthesia was induced with iv midazolam 0.04 mg/kg and vecuronium 0.10 mg/kg.I-gel and classic LMAs were inserted in I and C groups,respectively,after induction of anesthesia.The success rate of LMA placement at first attempt,LMA placement time,airway sealing pressure,peak airway pressure,leaks and hypoxemia,and complications (nauseas and vomiting,bucking,aspiration and blood stain on the LMAs,sore throat and hoarseness within 24 h after surgery) were recorded.Correct position of the LMAs was verified by fiberoptic bronchoscopy.Results The success rate of LMA placement were 100 ％ in both groups.The success rate of LMA placement at first attempt and fiberoptic bronchoscope scores were higher,the LMA placement time was significantly shorter,and the incidence of blood stain on the LMAs and sore throat were significantly lower in group Ⅰ than in group C (P ＜ 0.05).A transient increase in airway pressure and leaks occurred in 5 patients in group C,and the airway pressure returned to normal and no leaks developed after treatment.No transient increase in airway pressure and leaks occurred in group Ⅰ.Hypoxemia was not found in both groups.Conclusion The placement of I-gel LMA is easier than that of Classic LMA and the success rate of placement at first attempt is high,with fewer complications.I-gel LMA can be safely and effectively used for airway management in patients undergoing radical mastectomy.