摘要
目的观察i-gel喉罩用于老年患者泌尿外科腔镜手术的临床效果。方法择期泌尿外科腔镜手术老年患者40例，年龄65-78岁，ASAI～Ⅲ级，随机分为i-geI喉罩组（I组）和气管插管组（E组）。记录插管（喉罩）前5min（T1）、插管（喉罩）后1min（T2）、拔管（喉罩）前1min（T3）及拔管（喉罩）后1min（T4）的MAP和HR，记录术中PnCO2、SpO2和气道峰压（Ppeak），监测麻醉后1h内动脉血气。记录拔管（喉罩）时间，记录术后呛咳躁动、咽喉痛、声嘶等不良反应情况。结果与T1时比较，T2时E组MAP明显升高，HR明显增快（P〈0．05）。与T3时比较，T4时E组MAP明显升高，HR明显增快（P〈0．05）。与I组比较，T2、T4时E组MAP明显升高，HR明显增快（P〈0．05）。I组拔出喉罩时间（15．6±1．2）min，明显短于E组的（28．3±1．1）min（P〈0．05）。E组术后呛咳躁动明显多于I组（P〈0．05）。结论全麻i-gel喉罩通气在老年患者泌尿外科腔镜手术中优于气管插管，更易于维持血流动力学稳定，减少对呼吸道损伤，有利于呼吸功能保护，缩短了拔管时间。患者术后并发症少，更安全舒适地度过围术期。
Objective To observe the safety and efficacy of i-gel laryngeal mask airway used in urologic laparoscopy surgery of elderly patients. Methods Forty patients, ASA I -III, undergoing the urologic laparoscopy surgery, were randomized into two groups： i gel laryngeal mask airway group（group I）and tracheal tube group（group E）. The HR, interval noninvasive MAP of 5 minutes before and after intubation or extubation were monitored. The Pro-CO2, SpO2 ,Ppeak, 60 minutes after insertion as well as complications were recorded. Results The MAP and HR of group I after intubation and extubation were less than those in group E（P〈0.01）. The MAP and HR of group I after intubation and extubation were similar with those before. The MAP and HR of group E after intubation and extubation were more than those before（P〈0.01）. The PET CO2, SpO2, Ppeak, 60 minutes after insertion were similar between the two groups. Complications in group I were less than group E（P%0.05）. Conclusion Ventilation with i-gel LMA in elderly patients undergoing urologic laparoscopy surgery is better than tracheal tube in keeping stable hemodynamics, producing less stress responses, having less complications and having rapid recovery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第12期1196-1198,共3页
Journal of Clinical Anesthesiology
