国际麻醉学与复苏杂志   2018, Issue (5): 8-8
    
低流量新鲜气体下观察风箱法用于判断喉罩漏气的有效性和安全性
李博, 李秀娟, 季锋, 陈辉1()
1.上海长海医院
Safety and effectiveness of the observing bellow method under minimal fresh gas flow anesthesia for assessing air leakage of the laryngeal mask airway
 全文:
摘要:

目的 评价低流量新鲜气体下观察风箱法用于判断喉罩漏气的有效性和安全性。 方法 选择喉罩通气下全身麻醉患者816例,全身麻醉诱导后置入喉罩,低流量新鲜气体下分别应用观察风箱法和听诊触诊法判断是否发生喉罩漏气,记录两种判断方法所用时间及结果,计算两种方法各自的漏判率和误判率。 结果 首次置入喉罩后漏气发生率3.68%。两种方法各应用849次:其中观察风箱法判断为漏气33次,无漏判、误判;听诊触诊法判断为漏气35次,其中33次确为漏气,2次误判,误判率0.25%,无漏判。两种方法误判率、漏判率比较差异无统计学意义(P=0.5)。对于两种方法均判断为漏气的(32次),观察风箱法用时(5.3±0.9) s,听诊触诊法用时(4.0±1.1) s,差异有统计学意义(P<0.01)。对于两种方法均判断为无漏气的(814次),观察风箱法用时(23.2±3.9) s,听诊触诊法用时(47.2±6.9) s,差异有统计学意义(P<0.01)。 结论 低流量新鲜气体下观察风箱法判断喉罩漏气操作简单,评估无漏气时明显较听诊触诊法耗时短,结果可靠且便于连续观察,具备安全性和有效性。

关键词: 喉罩; 呼吸,人工
Abstract:

Objective To evaluate the safety and effectiveness of the observing bellow method under minimal fresh gas flow anesthesia for assessing air leakage of the laryngeal mask airway. Methods Eight hundred and sixteen patients who underwent general anesthesia with a laryngeal mask airway were included in this study. Air leakage of laryngeal mask was assessed by using both the observing bellow method and the auscultation and palpation method. The time spent in executing these two methods and their assessment results were recorded. The rates of both missing or incorrect assessments were calculated. Results Air leakage of laryngeal mask occurred in 30 of 816 patients(3.68%). No missing and incorrect assessment was made with the observing bellow method. However, 2 incorrect, but no missing assessments were made with the auscultation and palpation method. The validity and accuracy of the assessment with two methods were comparable. However, observing bellow method took longer (5.3±0.9) s to identify leakage than the auscultation and palpation method (4.0±1.1) s did (P<0.01), but determined non-leakage of the laryngeal mask much faster (23.2±3.9) s than the auscultation and palpation method (47.2±6.9) s did (P<0.01).  Conclusions The observing bellow method is safe, simple, and convenient for assessing air leakage of the laryngeal mask under minimal fresh gas flow anesthesia, especially combined with the auscultation and palpation method.

Key words: Laryngeal mask; Respiration, artificial