不同方法选择经典型喉罩型号在女性患者全麻中的应用效果

摘要

Objective To compare the clinic efficacy of two methods of classic laryngeal mask airway(LMA) size selection used in breast surgery under general anesthesia. Methods Forty female patients undergoing breast surgery,ASA I-Ⅱ,were divided randomly into group A,selecting LMA size based on standard weight,group B,seleting LMA size according adjusted method. After induction with propofol and fentanyl iv,patients were inserted selected LMA. Anesthesia was maintained with propofol and sevoflu-rane,remifentanil. Oropharyngeal leak pressure(OLP),inserting time,number of insertion attempts and mucosal injury were record-ed. Results There were no significant differences between group A and group B in VT,PetCO2,Ppeak,Cp and OLP. Inserting time of LMA in group A (35±5)s was shorter than that (28±3)s in group B (P<0.05). There was higher incidence of sore throat in group A than group B (P<0.05). there was no significant difference in complications of LMA removal between two groups ,such as mova-tion during insertin,mucosal injury,cough and hoarseness after removal. Conclusion For female adult population,selection LMA size by adjusted method (size 4 if body height is more tha 160cm,otherwise size 3) may be more appropriate to limit occurrence of sore throat, with enough glottic seal for positive pressure ventilation.%目的：比较按不同方法选择经典型喉罩（LMA）大小在女性患者乳腺手术全麻中的应用效果。方法女性乳腺手术患者60例，根据选择喉罩型号的方法不同，随机分为3组。其中A组（n=30），按标准体重选择；B组（n=30）按修正后方法选择。所有患者依次注入芬太尼2μg/kg，丙泊酚2.5mg/kg后，由同一名麻醉科医师插入LMA。持续泵注丙泊酚、瑞芬太尼维持全麻。结果两组患者间各时点SBP、DBP、HR、PETCO2、Ppeak、胸肺顺应性（Cp）及气道密闭压（OLP）等比较没有统计学差异（P＞0.05）。 A 组LMA 置入时间明显长于 B 组，分别为（35±5）s 与（28±3）s（P＜0.05），术后咽痛分别为10例（13%）和3例（10%）（P＜0.05）。两组一次置入成功率、及相关并发症组间比较无统计学差异（P＞0.05）。结论成年女性患者依据标准体重的修正方法选择喉罩，更易置入，口咽部损伤较轻。