Objective To compare the effects of the third generation of laryngeal mask ( PLMA) and the I-gel laryngeal mask (I-gel LMA) on respiratory mechanics during laparoscopic cholecystectomy .Methods Sixty-eight patients undergoing laparoscopic cholecystectomy under general anesthesia were randomly divided into PLMA group and I -gel group ,34 in each group .PLMA and I-gel LMA were inserted respectively for anesthesia .Respiratory mechanics parameters were monitored and compared between the two groups . Results The dynamic compliance at time of LMA insertion ,pneumoperitoneum started ,10 min after pneumoperitoneum and at the end of pneumoperitoneum in the I-gel LAM group were significantly higher than that in the PLMA group (P<0.05).The EtCO2 at the time of LMA insertion and pneumoperitoneum started in the PLMA group were significantly higher than that in the I -gel LAM group ( P <0.05 ) .No differences in the resistance ,work of breathing ,minute ventilation and peak airway pressure was found at the four time points between the two groups .None of the laryngeal mask insertion failure occurred in the both two groups ,and the LMA insertion time in the two groups had no significant difference .Conclusion As compared to I-gel LMA,PLMA obtains higher sealing pressure and larger drainage tube which can produce sufficient mechanical ventilation and oxygenation .These advantages make PLMA becomes a more suit-able ventilatory device in laparoscopic surgery than I-gel LMA.%目的：比较第三代喉罩（ proseal laryngeal mask airway ，PLMA）与I－gel喉罩在腹腔镜胆囊切除手术中对患者呼吸力学的影响。方法选择全麻下择期行腹腔镜胆囊切除术患者68例，采用分层区组随机化分为PLMA组和I－gel组各34例，分别在手术中插入PLMA喉罩和I－gel喉罩进行麻醉。比较两组患者喉罩插入时（ T0）、气腹开始（ T1）、气腹后10 min（ T2）、气腹结束时（ T3）的呼吸力学指标，以及喉罩沾血、恶心呕吐、咽喉痛和分泌物过多等不良反应的发生率。结果 PLMA组患者各时点的动态顺应性均明显低于I－gel组患者，而在T0和T1时呼气末二氧化碳分压（ EtCO2）值明显高于I－gel组患者，差异均有统计学意义（ P＜0．05）。两组患者T0～T3的阻力、呼吸功、每分钟通气量、气道峰压，以及不良反应发生率比较差异均无统计学意义（ P＞0．05）。结论 PLMA相较于I－gel喉罩具有更高的密封压力、较大的引流管，能产生足够的机械通气和氧合作用，更适合应用于腹腔镜胆囊切除手术中。
展开▼
