国际麻醉学与复苏杂志   2011, Issue (6): 10-10
    
SLIPA喉罩与PLMA喉罩在短小全麻手术中的气道管理比较
何德廷, 李建军1()
1.安徽省霍邱县中医院
SLIPA LMA LMA and PLMA in short anesthesia airway management in comparison
 全文:
摘要:

何德廷1 李建军2 [摘要] 目的 比较SLIPA(Streamlined Liner of Pharyngeal Airway)喉罩与PLMA(laryngeal mask airway ProSeal)喉罩在短小全麻手术中的气道管理效果。方法 选择60例,性别不限,年龄20~61岁,体重47~78kg, ASAⅠ或Ⅱ级,择期全麻下短小手术的患者。体重指数(BMI)<30,无喉罩禁忌证,随机分成两组:分别是SLIPA通气组(S组)和PLMA通气组(P组)。记录患者恶心呕吐、呛咳、声嘶、返流误吸,通气喉罩表面粘血,术毕和术后24小时随访有无咽痛等不良反应的发生情况。喉罩置入难易性(容易:15s内一次性置入成功;稍难:≥15S一次置入成功;困难:2次置入成功或更换型号置入;失败:2次置入或更换型号后均未成功。)和术中通气情况。结果 .两组喉罩插入的成功率相似。通气道插入后,S组2例、P组6例需要进一步调整位置方可进行间歇正压通气(internittent positive pressure ventilation, IPPV);术中P组有5例需要重新调整方可维持IPPV,S组均顺利完成手术全程IPPV(P<0.05)。两组经调整后SpO2, PETCO2均在正常范围,术前常规置入胃管,均未发生返流误吸和胃胀气情况。与P组相比较,S组喉罩后粘血和术毕咽痛的发生率有统计学意义P<0.05)。术后24小时咽痛的发生率无统计学意义(P> 0.05)。结论。SLIPA通气道和PLMA通气道置入简单,气道密封性好,可有效的保证通气,不良反应少。SLIPA通气道的插入操作更容易,同时也没有充气罩,不会因为充气过度或一氧化碳和二氧化碳弥散而导致罩内压增高,维持IPPV较PLMA更稳定。SLIPA喉罩用于短小全麻手术患者气道管理的效果更好。

关键词: SLIPA通气道; PLMA 通气道; 呼吸; 间歇正压通气
Abstract:

ay) laryngeal mask airway and PLMA (laryngeal mask airway ProSeal) laryngeal mask anesthesia in the short airway management in effect. Methods 60 patients, male or female, age 20 to 61 years old, weighing 47 ~ 78kg, ASA Ⅰ or Ⅱ short elective surgery under general anesthesia patients. Body mass index (BMI) <30, no contraindications LMA, were randomly divided into two groups: namely, SLIPA ventilation group (S group) and PLMA ventilation group (P group). Records were nausea, vomiting, cough, hoarseness, regurgitation and aspiration, laryngeal mask ventilation surface sticky blood, 24 hours of surgery and postoperative sore throat and other follow-up whether the incidence of adverse reactions. Ease of LMA insertion (easy: 15s in a one-time placement success; a little difficult: ≥ 15S success of a placement; difficulty: 2 times into a successful model placement or replacement; failed: 2 times after the implantation or replacement models without success.) and intraoperative ventilation situation. Results. Two LMA insertion success rates were similar. Airway inserted, S group 2 patients, P 6 patients need to be conducted to further adjust the position of intermittent positive pressure ventilation (internittent positive pressure ventilation, IPPV); patients in P group only 5 patients need to re-adjust to maintain IPPV, S group were successfully operated throughout the IPPV (P <0.05). The two groups after adjustment SpO2, PETCO2 were in the normal range, normal preoperative gastric tube placement, aspiration and regurgitation did not occur bloating situation. Compared with the P group, S group after laryngeal mask sore throat sticky blood and the incidence of surgery was statistically significant P <0.05). 24 hours after the incidence of sore throat was no significant (P> 0.05). Conclusion. SLIPA PLMA airway Airway and simple insertion, airway sealing, and can effectively guarantee ventilation, adverse reactions. SLIPA airway insertion operation easier, but also does not cover inflation, not because of hyperinflation, or diffusion of carbon monoxide and carbon dioxide pressure caused by increased cover to maintain IPPV is more stable than the PLMA. SLIPA laryngeal mask anesthesia for short surgical airway management of patients better.

Key words: SLIPA airway; PLMA airway; Breathing; Intermittent positive pressure ventilation