摘要
目的探讨颅内血管畸形介入术中应用喉罩(LMA)通气行全身麻醉对循环功能和术后恢复的影响。方法 80例颅内血管畸形拟行血管内介入术患者随机均分为LMA组(L组)与气管插管组(T组),L组采用LMA置入行全身麻醉,T组采用传统气管插管行全身麻醉,两组麻醉诱导均以咪达唑仑0.1～0.2mg/kg、丙泊酚1.0～1.5mg/kg、芬太尼3～5μg/kg、维库溴铵0.08～0.1mg/kg,维持均采用持续输注瑞芬太尼0.1～0.12μg·kg-1·min-1复合丙泊酚3.5～5.0mg·kg-1·h-1,记录两组患者麻醉前(T0)、气管插管(LMA插入)后10min(T1)、气管拔管(LMA拔除)前(T2)、气管拔管(LMA拔除)后10min(T3)的HR、MAP,并分别记录两组拔管(LMA拔除)时间、清醒时间和拔管(LMA拔除)时呛咳反应发生率。记录术后咽部不适、声音嘶哑等不良反应的发生情况。结果 T1～T3时,L组HR明显慢于、MAP明显低于T组(P<0.05)。L组患者拔管(LMA拔除)时间和术后清醒时间明显短于T组(P<0.05),拔管(LMA拔除)时呛咳反应发生率明显低于T组(P<0.05)。术后随访72h,咽部不适、声音嘶哑等不良反应发生率L组明显低于T组(P<0.05)。结论颅内血管畸形介入手术选择LMA通气心血管反应小,术后恢复时间短,并发症少,具有推广价值。
Objective To evaluate the effects of laryngeal mask（LMA） on circulation function and postoperative recovery during interventional operation for intracranial vascular malformation. Methods Eighty patients with intracranial vascular malformation, scheduled for interventional operation, were equally radomized into group LMA（group L） and group endotracheal intubation （group T）. LMA and trachea intubation was inserted respectively in group L and group T. Patients in both groups was induced with 0.1-0.2 mg/kg of midozolam, 1.0-1.5 mg/kg of propofol, 3 5 μg/ kg of fentanyl and 0.08-0.1 mg/kg of vecuronium, and maintained with infusion of remifentanyl at 0.1-0. 12μg.kg-1 min-1 combined with propofol at 3.5 5.0 mg.kg-1 .h-1. HR, MAP at the time of before anesthesia（T0）, 10 minutes after endotracheal intubation（LMA） placement（T1 ）, before the removal of endotracheal intubation（LMA）（T2）, 10 minutes after the removal of endotracheal intubation（LMA） （Ta）were recorded. The time when extubation or awake and the incidence of bucking were also recorded. The adverse reactions were recorded in the 72 hours follow-up after the operation, including pharyngeal discomfort, rustiness. Results HR, MAP at the time of T1-Ta was significantly lower in group L than that in group T （P〈0. 05）. The time when extubation （LMA） and awake was earlier in group L than that in group T. The incidence of adverse reactions in group L was less compared with group T（P〈0. 05）. Conclusion LMA can be a safe choice for intracranial vascular malformation patients undergoing interventional operation, which lead to minor cardiovascular response and little complications.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第6期580-582,共3页
Journal of Clinical Anesthesiology
关键词
喉罩
气管插管术
全身麻醉
安全性
Laryngeal mask airway
Endotracheal intubation
General anesthesia
Safety
