喉罩通气应用于小儿全身麻醉的临床观察.pdf

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1、·1538·史堡全医堂201j年10箜!鲞箜翅!!!翌!!Q!!!!!：!!：·全科II缶床论著·喉罩通气应用于小儿全身麻醉的临床观察付学明，安振平，熊伟，左星，蒋思源，万娇娇【摘要】目的探讨喉罩通气应用于小儿全身麻醉的可行性和安全性。方法选择80例择期手术患儿，随机分为喉罩组(L组)和静脉全麻组(M组)，每组40例。两组患儿均采用面罩吸入6％七氟醚麻醉诱导，然后静脉注射咪唑安定O．05ms／kg、芬太尼4g／kg、静脉泵注异丙酚4ms／(kg·h)，L组在手术开始前放置喉罩通气，M组经麻醉机面罩通气给氧，两组患儿在术中均持续吸入1％一2％七氟烷，手术结束前3min停止给

2、予异丙酚和七氟醚。记录麻醉前Tn，麻醉5分钟T。，麻醉20分钟T，手术结束L各时点的MAP、SPO、HR，记录术中患儿躁动，呼吸道梗阻，误吸的发生情况以及两组患者手术时间和清醒时间。结果L组苏醒时间短于M组，呼吸道梗阻M组明显高于L组。L组与M组比较，T0、T、1r3各时点的HR、SPO、MAP之间比较差异均无统计学意义，Tl时HR、SPO2、MAP组间比较差异均存在统计学意义。结论小儿全麻下使用喉罩通气的麻醉方法具有操作简单，血流动力学平稳，没有呼吸系统并发症，是一种值得推广的小儿麻醉方法。【关键词】喉罩；小儿；全身麻醉【中图分类号】R614．2【文献标识码】A【文章编

3、号】1674-4152(2013)10．1538-02LaryngealMaskAirwayforGeneralAnesthesiainChildren：aClinicalObservationFUXne—ming，ANZhen-ping，XIONGWei，eta1．DepartmentofAnesthesiology，XiaoganCentralHospital，Xiaogan432100，Hubei，China【Abstract】ObjectiveTostudytheeffectandsafetyoflaryngealmaskairway(LMA)ongenerala

4、nesthesiainchildren．MethodsAtotalof80ChildrenundergoingelectiveoperationscheduledwererandomizedtoLMP(L)groupandIntravenousanesthesia(M)groupwith40caseseach．Bothgroupsreceivedmaskanesthesiainductionwith6％sevoflurane，followedbyintra—venousmidazolam0．05ms／kgandfentanyl4g／kg，andintravenousinf

5、usionofpropofol4ms／kg．h．Theventilationwasper-formedwithLMAinthegroupLandanesthesiamachineingroupMbeforethestartofsurgery．Bothgroupswereadministratedwithcontinuoussevoflurane．Propofolandsevofluranewerecanceled3minutesbeforetheendofoperation．MAP，HRandSpO2onTo(pre—anesthesia)，Tl(5minutesafte

6、rthebeginningofanesthesia)，T2(20minutesafterthebeginningofanesthesia)andT3(endoftheoperation)wererecorded．Theincidencesofpostoperativeagitation，airwayobstructionandaspirationwererecorded．Theoperationtimeandrecoverytimeswereobserved．ResultsTherecoverytimesofGroupLwasshorterthanthatingroupM

7、．TheincidenceofairwayobstructioningroupMwashigherthanthatingroupL．TherewasnodifferenceinthelevelsofMAP，HRandspo2onTo，T2，T3；butthediferenceinMAP，HRandSpO2onTlwasstatisticalsignificant．ConclusionLaryngealmaskairwayforgeneralanesthesiaissafeandeasy．Itcankeepastablehemo