LMA喉罩和气管内全麻复合连续硬膜外麻醉方法应用在腹腔镜胆囊切除术中的临床分析
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摘要
目的探讨LMA喉罩和气管内全麻复合连续硬膜外麻醉方法应用在腹腔镜胆囊切除术中的临床效果。方法2015年1月—2017年12月方便选择该院收治的98例行腹腔镜胆囊切除术治疗患者作为研究对象,利用简单随机法分为对照组和观察组,每组患者49例,对照组应用气管内全麻复合连续硬膜外麻醉方法,观察组应用LMA喉罩复合连续硬膜外麻醉方法,观察对比两组患者血流动力学各项指标稳定情况和苏醒状况。结果观察组患者拔管(喉罩)前即刻观察组MAP和HR分别为(91.32±4.25)mmHg、(73.44±4.07)次/min,均低于对照组(105.35±3.24)mmHg、(83.44±3.15)次/min,拔管(喉罩)后即刻观察组MAP和HR分别为(92.41±3.92)mmHg、(72.44±3.85)次/min,均低于对照组(118.23±3.82)mmHg、(88.95±3.72)次/min(P<0.05),但两个时刻两组患者SpO_2差异无统计学意义(P>0.05);相较于对照组,观察组患者拔管(喉罩)时间较短,苏醒时间较早(P<0.05)。结论在腹腔镜胆囊切除术治疗过程中,LMA喉罩复合连续硬膜外麻醉方法效果理想,值得广泛推广。
Objective To study the clinical effect of LMA laryngeal mask, endotracheal general anesthesia combined with continuous epidural anesthesia in the laparoscopic cholecystectomy. Methods 98 cases of patients with laparoscopic cholecystectomy treated in our hospital from January 2015 to December 2017 were selected and randomly divided into two groups with 49 cases in each, the control group applied the endotracheal general anesthesia combined with continuous epidural anesthesia, while the observation group used the LMA laryngeal mask combined with continuous epidural anesthesia, and the steady condition and awakening status of various indexes of hemodynamics were compared between the two groups. Results The MAP and HR in the observation group before tube drawing(laryngeal mask) were lower than those in the control group, [(91.32±4.25)mmHg,(73.44±4.07)beats/min vs(105.35±3.24) mmHg,(83.44±3.15)beats/min], and the MAP and HR in the observation group after tube drawing(laryngeal mask) were lower than those in the control group[(92.41±3.92)mmHg,(72.44±3.85)beats/min vs(118.23±3.82)mmHg,(88.95±3.72)beats/min](P<0.05), and the difference in the SpO_2 between the two groups was not obvious(P>0.05), and the tube drawing time(laryngeal mask) in the observation group was shorter, and the awakening time was earlier(P<0.05). Conclusion The effect of LMA laryngeal mask combined with continuous epidural anesthesia in the laparoscopic cholecystectomy is ideal, which is worth wide promotion.
Objective To study the clinical effect of LMA laryngeal mask, endotracheal general anesthesia combined with continuous epidural anesthesia in the laparoscopic cholecystectomy. Methods 98 cases of patients with laparoscopic cholecystectomy treated in our hospital from January 2015 to December 2017 were selected and randomly divided into two groups with 49 cases in each, the control group applied the endotracheal general anesthesia combined with continuous epidural anesthesia, while the observation group used the LMA laryngeal mask combined with continuous epidural anesthesia, and the steady condition and awakening status of various indexes of hemodynamics were compared between the two groups. Results The MAP and HR in the observation group before tube drawing(laryngeal mask) were lower than those in the control group, [(91.32±4.25)mmHg,(73.44±4.07)beats/min vs(105.35±3.24) mmHg,(83.44±3.15)beats/min], and the MAP and HR in the observation group after tube drawing(laryngeal mask) were lower than those in the control group[(92.41±3.92)mmHg,(72.44±3.85)beats/min vs(118.23±3.82)mmHg,(88.95±3.72)beats/min](P<0.05), and the difference in the SpO_2 between the two groups was not obvious(P>0.05), and the tube drawing time(laryngeal mask) in the observation group was shorter, and the awakening time was earlier(P<0.05). Conclusion The effect of LMA laryngeal mask combined with continuous epidural anesthesia in the laparoscopic cholecystectomy is ideal, which is worth wide promotion.
引文
[1]项燚,郑自富,沈培,等.LMA(Supreme)喉罩复合静脉全麻应用于腹腔镜胆囊切除术的临床观察[J].中国医学创新,2015,12(2):61-64.
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[5]徐夏,喻学海,彭蔚,等.BIS监测在喉罩麻醉下腹腔镜胆囊切除术中对血流动力学的影响[J].哈尔滨医科大学学报,2015,49(1):63-65.
[6]唐超江,王从兵,王进龙,等.腹腔镜胆囊切除术全身麻醉应用LMA-Supreme喉罩效果观察[J].交通医学,2015,29(1):78-79.
[7]徐西通,赵林,孟丽,等.LMA双管喉罩用于腹腔镜胆囊切除术患者气道管理临床分析[J].中国伤残医学,2016,24(7):65-67.
[8]吴昊.喉罩麻醉与气管插管麻醉对老年患者腹腔镜全麻诱导期血流动力学及应激激素的比较研究[J].中国实验诊断学,2016,20(8):1278-1281.
[2]李晓慧,陈学新,吕丹妮,等.气管内插管与喉罩对全麻腹腔镜胆囊切除术后下呼吸道感染的影响[J].临床麻醉学杂志,2016,32(4):400-401.
[3]曹德钧,祖存.不同全麻方式在老年高血压患者行单孔腹腔镜胆囊切除术的比较[J].昆明医科大学学报,2015,36(9):98-101.
[4]郎中兵,李红梅,陈延福,等.两种类型喉罩在腹腔镜胆囊切除术中的临床应用[J].重庆医学,2015,44(13):1782-1783.
[5]徐夏,喻学海,彭蔚,等.BIS监测在喉罩麻醉下腹腔镜胆囊切除术中对血流动力学的影响[J].哈尔滨医科大学学报,2015,49(1):63-65.
[6]唐超江,王从兵,王进龙,等.腹腔镜胆囊切除术全身麻醉应用LMA-Supreme喉罩效果观察[J].交通医学,2015,29(1):78-79.
[7]徐西通,赵林,孟丽,等.LMA双管喉罩用于腹腔镜胆囊切除术患者气道管理临床分析[J].中国伤残医学,2016,24(7):65-67.
[8]吴昊.喉罩麻醉与气管插管麻醉对老年患者腹腔镜全麻诱导期血流动力学及应激激素的比较研究[J].中国实验诊断学,2016,20(8):1278-1281.