国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
12期
1089-1093,1104
,共6页
全身麻醉%乳腺手术%喉罩%血流动力学%并发症
全身痳醉%乳腺手術%喉罩%血流動力學%併髮癥
전신마취%유선수술%후조%혈류동역학%병발증
General anesthesia%Breast surgery%Laryngeal mask%Hemodynamic response%Complications
目的 对可弯曲喉罩、普通喉罩以及双管喉罩用于全麻乳腺手术的安全性进行随机对照研究. 方法 拟行全麻乳腺手术的患者60例,美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级,年龄27岁～77岁,参照随机数字表法将患者随机分为3组(每组20例):可弯曲喉罩组(A组)、普通喉罩组(B组)及双管喉罩组(C组).常规麻醉诱导后,经口置入喉罩,记录麻醉诱导前(基础值)、喉罩置入前即刻、喉罩置入即刻及喉罩置入后1、2、3、5、10 min的心率(heart rate,HR)、血压(blood pressure,BP)和脑电双频指数(bispectral index,BIS),观察患者的血流动力学变化及其并发症. 结果 3组患者均顺利完成喉罩置入,一次置入成功率均高于90％,插管时间短(均＜l min).麻醉诱导后,3组患者BIS均显著降低[A组(93±5) vs(39±7),B组(96±3) vs(39±9),C组(95±5)vs(39±9),P＜0.05],A组BP显著降低[收缩压(systolic blood pressure,SBP)(134±13) mmHg vs (109±12)mmHg(1 mmHg=0.133 kPa),舒张压(diastolic blood pressure,DBP)(77±10) mmHg vs (64±9) mmHg,平均动脉压(mean arterypressure,MAP) (90±1 1)mmHg vs (74±9) mmHg,P＜0.05],B组患者HR和BP均未显著降低,C组患者HR和BP均显著降低[HR (77±10)次/min vs (68±9)次/min,SBP (127±28) mmHg vs (107±15) mmHg,DBP (72±14) mmHg vs (58±11) mmHg,MAP(85±15) mmHg vs (70±10) mmHg,P＜0.05].在喉罩置入和拔除期间,血流动力学平稳.麻醉诱导、喉罩置入期间,3组各项指标差异无统计学意义,但是A组患者术后并发症发生率低. 结论 普通喉罩、双管喉罩和可弯曲喉罩插管成功率高、血流动力学平稳,能够有效地减轻插管及拔管的血流动力学反应.较之普通喉罩和双管喉罩,可弯曲喉罩可以降低插管及拔管并发症.
目的 對可彎麯喉罩、普通喉罩以及雙管喉罩用于全痳乳腺手術的安全性進行隨機對照研究. 方法 擬行全痳乳腺手術的患者60例,美國痳醉醫師協會(ASA)分級Ⅰ～Ⅱ級,年齡27歲～77歲,參照隨機數字錶法將患者隨機分為3組(每組20例):可彎麯喉罩組(A組)、普通喉罩組(B組)及雙管喉罩組(C組).常規痳醉誘導後,經口置入喉罩,記錄痳醉誘導前(基礎值)、喉罩置入前即刻、喉罩置入即刻及喉罩置入後1、2、3、5、10 min的心率(heart rate,HR)、血壓(blood pressure,BP)和腦電雙頻指數(bispectral index,BIS),觀察患者的血流動力學變化及其併髮癥. 結果 3組患者均順利完成喉罩置入,一次置入成功率均高于90％,插管時間短(均＜l min).痳醉誘導後,3組患者BIS均顯著降低[A組(93±5) vs(39±7),B組(96±3) vs(39±9),C組(95±5)vs(39±9),P＜0.05],A組BP顯著降低[收縮壓(systolic blood pressure,SBP)(134±13) mmHg vs (109±12)mmHg(1 mmHg=0.133 kPa),舒張壓(diastolic blood pressure,DBP)(77±10) mmHg vs (64±9) mmHg,平均動脈壓(mean arterypressure,MAP) (90±1 1)mmHg vs (74±9) mmHg,P＜0.05],B組患者HR和BP均未顯著降低,C組患者HR和BP均顯著降低[HR (77±10)次/min vs (68±9)次/min,SBP (127±28) mmHg vs (107±15) mmHg,DBP (72±14) mmHg vs (58±11) mmHg,MAP(85±15) mmHg vs (70±10) mmHg,P＜0.05].在喉罩置入和拔除期間,血流動力學平穩.痳醉誘導、喉罩置入期間,3組各項指標差異無統計學意義,但是A組患者術後併髮癥髮生率低. 結論 普通喉罩、雙管喉罩和可彎麯喉罩插管成功率高、血流動力學平穩,能夠有效地減輕插管及拔管的血流動力學反應.較之普通喉罩和雙管喉罩,可彎麯喉罩可以降低插管及拔管併髮癥.
목적 대가만곡후조、보통후조이급쌍관후조용우전마유선수술적안전성진행수궤대조연구. 방법 의행전마유선수술적환자60례,미국마취의사협회(ASA)분급Ⅰ～Ⅱ급,년령27세～77세,삼조수궤수자표법장환자수궤분위3조(매조20례):가만곡후조조(A조)、보통후조조(B조)급쌍관후조조(C조).상규마취유도후,경구치입후조,기록마취유도전(기출치)、후조치입전즉각、후조치입즉각급후조치입후1、2、3、5、10 min적심솔(heart rate,HR)、혈압(blood pressure,BP)화뇌전쌍빈지수(bispectral index,BIS),관찰환자적혈류동역학변화급기병발증. 결과 3조환자균순리완성후조치입,일차치입성공솔균고우90％,삽관시간단(균＜l min).마취유도후,3조환자BIS균현저강저[A조(93±5) vs(39±7),B조(96±3) vs(39±9),C조(95±5)vs(39±9),P＜0.05],A조BP현저강저[수축압(systolic blood pressure,SBP)(134±13) mmHg vs (109±12)mmHg(1 mmHg=0.133 kPa),서장압(diastolic blood pressure,DBP)(77±10) mmHg vs (64±9) mmHg,평균동맥압(mean arterypressure,MAP) (90±1 1)mmHg vs (74±9) mmHg,P＜0.05],B조환자HR화BP균미현저강저,C조환자HR화BP균현저강저[HR (77±10)차/min vs (68±9)차/min,SBP (127±28) mmHg vs (107±15) mmHg,DBP (72±14) mmHg vs (58±11) mmHg,MAP(85±15) mmHg vs (70±10) mmHg,P＜0.05].재후조치입화발제기간,혈류동역학평은.마취유도、후조치입기간,3조각항지표차이무통계학의의,단시A조환자술후병발증발생솔저. 결론 보통후조、쌍관후조화가만곡후조삽관성공솔고、혈류동역학평은,능구유효지감경삽관급발관적혈류동역학반응.교지보통후조화쌍관후조,가만곡후조가이강저삽관급발관병발증.
Objective Randomized controlled research on the safety of the use of flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask in breast surgeries under general anesthesia.Methods Sixty ASA Ⅰ-Ⅱpatients aged 27 y-77 y weighing 51 kg-82 kg scheduled for breast surgery under general anesthesia were randomly divided into 3 groups (n=20),according to random number table:flexible laryngeal mask group (group A),classic laryngeal mask group (group B) and Supreme laryngeal mask group (group C).After induction of anesthesia,laryngeal mask insertion was performed,respectively.Noninvasive blood pressure (BP),heart rate (HR) and bispectral index(BIS) were recorded at the time before induction,the time before and just the time of laryngeal mask insertion,at 1,2,3,5,10 min after laryngeal mask insertion was complete.Observe the hemodynamic response and complications of laryngeal mask insertion.Results Patients of three groups had high one-time success rate above 90％,and short intubation time(＜1 min).BIS of three groups all decreased significantly[group A (93±5) vs (39±7),group B (96±3) vs (39±9),group C (95±5) vs (39±9),P＜0.05].In group A,BP was significantly decreased after induction [systolic blood pressure (SBP)(134±13) mmHg vs (109±12) mmHg (1 mmHg=0.133 kPa),diastolic blood pressure (DBP) (77±10) mmHg vs (64±9) mmHg,mean artery pressure (MAP) (90±11) mmHg vs (74±9) mmHg,P＜0.05].In group B,there was no significant change in BP and HR.While in group C,there was significant change in HR and BP [HR (77±10) bpm vs (68±9) bpm,SBP (127±28) mmHg vs (107±15) mmHg,DBP(72±14) mmHg vs (58±11) mmHg,MAP (85 ±15) mmHg vs (70±10) mmHg,P＜0.05].Insertion and extubation of laryngeal mask didn't cause violent hemodynamic responses.There were no significant differences among the hemodynamic responses of three groups,during the period of induction of anesthesia and laryngeal mask insertion.And the intubation time,recovery time and extubation time were not different among three groups.There were less complications of intubation and extubation observed in group A,compared with other two groups.Conclusions Flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask can all prevent hemodynamic responses to intubation,and flexible laryngeal mask has advantage in reducing complications produced by intubation than other two kinds of laryngeal mask.
