欧普乐喉罩用于髋关节置换手术的临床观察

摘要

目的：观察欧普乐喉罩用于髋关节置换手术患者静吸复合全身麻醉的人工气道的有效性、安全性及医患接受程度。方法78例髋关节置换手术患者，其中42例患者采用欧普乐喉罩静吸复合全身麻醉（OPLAC组），36例患者采用健侧卧位下轻比重腰硬联合麻醉（CESA组）。监测两组麻醉开始前、麻醉用药后10、30 min、1 h ，以及处理髓腔时呼吸及循环参数的变化，观察两组患者并发症发生情况，随访患者及手术医生对麻醉的满意度。结果 OPLAC组在麻醉诱导及麻醉维持中呼吸及循环都相对稳定；CESA组在麻醉后出现明显循环抑制及呼吸减慢，需要使用阿托品与多巴胺支持的病例明显多于OPLAC组；在处理髓腔时，OPLAC组循环及呼吸较平稳，而CESA组则有明显的循环波动；CESA组的谵妄发生率明显高于OPLAC组；OPLAC组的医患满意度明显优于C ES A组。结论欧普乐喉罩用于髋关节置换术手术患者的静吸复合全身麻醉人工气道安全、有效、医患满意度高。%Objective To observe the efficacy ,safety and patient acceptance of the artificial airway with the oro‐pharyngo‐laryn‐gead airway cap(OPLAC) for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia .Methods Sev‐enty eight cases of patients receiving the hip replacement surgery were included ,42 patients were to be adopted to establish artificial airway with the OPLAC for intravenous‐inhalation combined anesthesia ,another 36 patients treated with heath side‐lying position hypobaric spinal‐epidural anesthesia .There are two groups ,the oro‐pharyngo‐laryngead airway cap group(OPLAC ,n=42) and hy‐pobaric combined spinal‐epidural anesthesia group (CESA ,n=36) .Monitor the changes of respiratory and circulatory parameters of the two groups before the start of anesthesia ,anesthetic after 10 min ,30 min ,1 h ,and handling marrow ,observing occurrence of complications (delirium ,sore throat ,nausea ,vomiting ,deep vein thrombosis) ,following up the degree of satisfaction of patients and surgeons for anesthesia .Results The respiratory and circulatory parameters of the OPLAC group during anesthesia induction and maintenance were relatively stable ,on the other hand ,significant cyclic inhibition (blood pressure and heart rate decresing ) and re‐spiratory rate declining were observed in the CESA group after anesthesia ,cases with the use of atropine and dopamine significantly more than OPLAC group .The circulation and breath in the OPLAC group were relatively stable when handling marrow ,while cir‐culation fluctuating Significantly in the CESA group (blood pressure decreasing and heart rate increasing ) .The incidence of delirium in the CESA group was significantly higher than OPLAC group .The patient satisfaction of the OPLAC group was significantly bet‐ter than the CESA group .Conclusion The artificial airway with OPLAC for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia is safe ,effective ,and satisfactory .