摘要
目的比较Proseal型喉罩与气管插管用于腹腔镜胆囊切除术麻醉时的优、缺点。方法将30例需行腹腔镜胆囊切除术的患者随机分为Proseal型喉罩组(PL组,15例)和气管插管组(TI组,15例)。监测循环、呼吸功能、麻醉深度指数(CSI)。分别于麻醉诱导前(T0)、气管插管或置入喉罩1min时(T1)、气腹满意后(T2)、呼之能睁眼时(T3)、拔管或取出喉罩1min时(T4)测定并记录各监测指标。结果两组患者心率、平均动脉压在T1、T3、T4时差异具有统计学意义(P<0.05),TI组患者T1、T3时平均动脉压波动组内差异有统计学意义(P<0.05)。两组患者的呼气末二氧化碳分压和气道压在T2处组内差异有统计学意义(P<0.05),而组间差异无统计学意义(P>0.05),患者清醒及拔管或取出喉罩时潮气量组间、组内差异有统计学意义(P<0.05)。CSI在T3、T4处组间差异有统计学意义(P<0.05)。结论Proseal型喉罩较气管插管可明显降低心血管反应;对于短时间的CO2气腹腹腔镜胆囊切除术的麻醉,Proseal型喉罩较气管插管未明显影响通气量及呼气末二氧化碳分压(PET-CO2),麻醉苏醒期较气管插管平稳,CSI能较准确监测麻醉深度,指导苏醒期麻醉处理及用药。
Objective To compare anesthesia of Proseal laryngeal mask and tracheal intubation used for laparoscopic eholecystectomy in order to know the merit or demerit of two methods. Methods Thirty patients for laparoscopic cholecystectomy were randomly divided into two groups,group PL（15 cases） and groupTI （15 cases）. CSI was monitored besides respiratory, circulation function. All the monitored indexes were recorded at the time of the T0, T1, T2, T3, T4. Results As compared with the patients in group PL,the patients＇ HR and MAP in group TI changed significantly at T1, T3, T4 （P〈0.05）, and so did MAP in group TI at T1, T3 （P〈0.05） ; PETCO2 in group TI and grroup PL were all obviously different from each own prior at T2 （P〈0.05） ;however, at T3,T4,the change of HR,MAP and CSI in group TI were significant （P〈0. 05）. Conclusion Anesthesia of Proseal laryngeal mask can reduce the adverse cardiovascular effects;as far as short time anesthesia for laparoscopic cholecystectomy is concerned,anesthesia of Proseal laryngeal mask can not lessen effectively the ventilatory capacity and PETCO2 compared with tracheal intubation. Anesthesia analepsia of laryngeal mask is stable. CSI can monitor exactly depth of anesthesia and instruction anesthesia treatment or drugs in the stage of anesthesia analepsia.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第5期560-562,共3页
Chongqing medicine
关键词
喉罩
气管插管
腹腔镜胆囊切除术
麻醉
麻醉深度指数
laryngeal mask
tracheal intubation
laparoscopic cholecystectomy
anesthesia
CSI.
