• 綿陽(yáng)市中心醫(yī)院麻醉科（四川綿陽(yáng)，621000）;

【摘要】　目的　 比較喉罩全麻與氣管插管全麻兩種麻醉方法在小兒側(cè)臥位短小手術(shù)中的優(yōu)缺點(diǎn)。　方法　 2009年6月-2010年2月，將40例擇期行側(cè)臥位短小手術(shù)兒患，隨機(jī)分為喉罩全麻（L）組與氣管插管全麻（T）組，每組各20例。觀察患兒術(shù)中心率（HR）、平均動(dòng)脈壓（MAP）、脈搏血氧飽和度（SpO2）、氣道峰壓（Pmax），惡心嘔吐、術(shù)后躁動(dòng)等圍術(shù)期不良反應(yīng)。　結(jié)果　 T組插管后及拔管后即刻HR、MAP均高于L組患兒（P lt;0.05）；SpO2、Pmax在兩組之間比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05），T組患兒術(shù)后躁動(dòng)發(fā)生率明顯高于L組（P lt;0.05）。　結(jié)論　 喉罩可以安全、有效地用于小兒側(cè)臥位短小手術(shù)麻醉，且操作簡(jiǎn)便，插管期和拔管期心血管應(yīng)激反應(yīng)輕，術(shù)后躁動(dòng)發(fā)生率低。
【Abstract】　Objective　 To compare the safety and efficacy of laryngeal mask airway (LMA) and tracheal tube in lateral general anesthetic operation on children.　Methods　 From June 2009 to February 2010, 40 children scheduled to undergo general anesthesia for minor surgical procedures in lateral position were randomly divided into the laryngeal mask airway group (group L) and the tracheal tube group (group T) with 20 in each. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), top airway pressure (Pmax) of the patients were observed. In addition, side effects such as nausea, vomiting, and emergence agitation were also recorded.　Results　 HR and MAP of patients in group T were significantly higher than those of patients in group L after intubation and after extubation (P lt;0.05). There was no difference in Pmax and SpO2 between the two groups (P gt;0.05). The incidence of emergence agitation in group T was significantly higher than that in group L.　Conclusions　 LMA intubation can provide the same safe and effective ventilation as tracheal intubation for children undergoing lateral general anesthetic operation. LMA is superior to tracheal intubation in insertion response, and the incidence of emergence agitation is lower.

引用本文： 李秀澤,李衛(wèi),夏氫. 喉罩全麻在小兒側(cè)臥位手術(shù)中的應(yīng)用. 華西醫(yī)學(xué), 2011, 26(3): 421-423. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《華西醫(yī)學(xué)》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. 　李衛(wèi), 李秀澤, 暢文麗, 等. 喉罩-雷米芬太尼復(fù)合七氟醚或丙泊酚麻醉在燒傷整形術(shù)中的應(yīng)用[J]. 臨床麻醉學(xué)雜志, 2008, 24(6): 437-439.
2. 　張秦, 鄭宏. 利多卡因與芬太尼用于預(yù)防丙泊酚注射痛的比較性研究[J]. 新疆醫(yī)科大學(xué)學(xué)報(bào), 2008, 31(6): 714-716.
3. 　莊心良. 現(xiàn)代麻醉學(xué)[M]. 3版. 北京: 人民衛(wèi)生出版社, 2006: 1421-1424.
4. 　鄭穎, 連文潔, 王春英, 等. 喉罩與氣管插管用于全麻乳腺癌根治術(shù)的比較[J]. 臨床麻醉學(xué)雜志, 2007, 23(4): 288-290.
5. 　Bordes M, Semjen F, Degryse C, et al. Pressure-controlled ventilation is superior to volume-controlled ventilation with a laryngeal mask airway in children[J]. Acta Anaesthesiol Scand, 2007, 51(1): 82-85.
6. 　Wittmann PH, Wittmann FW. Laryngeal mask and gastric dilation[J]. Anesthesia, 1991, 46(11): 1083.
7. 　Nunez J, Hughes J, Wareham K, et al. Timing of removal of the laryngeal mask airway[J]. Anaesthesia, 1998, 53(2): 126-130.
8. 　Kitching AJ, Walpole AR, Blogg CE. Removal of the laryngeal mask airway in children: anaesthesized compared with awake[J]. Br J Anaesth, 1996, 76(6): 874-876.
9. 　孫瑛, 許文音, 胡潔. 曲馬多復(fù)合小劑量丙泊酚對(duì)小兒七氟醚麻醉術(shù)后躁動(dòng)的影響[J]. 上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2010, 30(1): 73-75.
10. 　汪忠玉, 魏薇, 鄭利民. 小劑量氯胺酮用于瑞芬太尼麻醉后痛覺(jué)過(guò)敏的臨床研究[J]. 中國(guó)實(shí)用醫(yī)藥, 2009, 4(4): 19-20.
11. 　Meyer RR, Munster P, Werner C, et al. Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children: a randomized controlled study[J]. Paediatr Anaesth, 2007, 17(1): 56-70.
  1. 1. 　李衛(wèi), 李秀澤, 暢文麗, 等. 喉罩-雷米芬太尼復(fù)合七氟醚或丙泊酚麻醉在燒傷整形術(shù)中的應(yīng)用[J]. 臨床麻醉學(xué)雜志, 2008, 24(6): 437-439.
  2. 2. 　張秦, 鄭宏. 利多卡因與芬太尼用于預(yù)防丙泊酚注射痛的比較性研究[J]. 新疆醫(yī)科大學(xué)學(xué)報(bào), 2008, 31(6): 714-716.
  3. 3. 　莊心良. 現(xiàn)代麻醉學(xué)[M]. 3版. 北京: 人民衛(wèi)生出版社, 2006: 1421-1424.
  4. 4. 　鄭穎, 連文潔, 王春英, 等. 喉罩與氣管插管用于全麻乳腺癌根治術(shù)的比較[J]. 臨床麻醉學(xué)雜志, 2007, 23(4): 288-290.
  5. 5. 　Bordes M, Semjen F, Degryse C, et al. Pressure-controlled ventilation is superior to volume-controlled ventilation with a laryngeal mask airway in children[J]. Acta Anaesthesiol Scand, 2007, 51(1): 82-85.
  6. 6. 　Wittmann PH, Wittmann FW. Laryngeal mask and gastric dilation[J]. Anesthesia, 1991, 46(11): 1083.
  7. 7. 　Nunez J, Hughes J, Wareham K, et al. Timing of removal of the laryngeal mask airway[J]. Anaesthesia, 1998, 53(2): 126-130.
  8. 8. 　Kitching AJ, Walpole AR, Blogg CE. Removal of the laryngeal mask airway in children: anaesthesized compared with awake[J]. Br J Anaesth, 1996, 76(6): 874-876.
  9. 9. 　孫瑛, 許文音, 胡潔. 曲馬多復(fù)合小劑量丙泊酚對(duì)小兒七氟醚麻醉術(shù)后躁動(dòng)的影響[J]. 上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2010, 30(1): 73-75.
  10. 10. 　汪忠玉, 魏薇, 鄭利民. 小劑量氯胺酮用于瑞芬太尼麻醉后痛覺(jué)過(guò)敏的臨床研究[J]. 中國(guó)實(shí)用醫(yī)藥, 2009, 4(4): 19-20.
  11. 11. 　Meyer RR, Munster P, Werner C, et al. Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children: a randomized controlled study[J]. Paediatr Anaesth, 2007, 17(1): 56-70.