目的探讨喉罩全麻在小儿短时间手术中的应用效果。方法选取拟接受短时间手术的患儿60例,随机分为研究组与对照组各30例。研究组根据患儿体重选择第三代喉罩,分别静脉注射阿托品0.01 mg/kg、舒芬太尼0.25 μg/kg、丙泊酚2 mg/kg;诱导至咽喉反射消失、下颌松弛、睫毛反射消失时安置喉罩。对照组患儿肌注氯胺酮(4~5 mg/kg)或静脉注射氯胺酮(1~2 mg/kg)。手术过程中观察并比较两组血压、心率、呼吸频率、血氧饱和度、最高血压及麻醉效果等。结果研究组患者麻醉后5 min及15 min心率、呼吸频率均显著低于对照组,差异有统计学意义(P<0.05)。研究组麻醉后5 min、15 min血氧饱和度与对照组比较,差异无统计学意义(P>0.05)。研究组5 min、15 min的最高血压均显著低于对照组,两组比较,差异有统计学意义(P<0.05)。研究组苏醒时间为(10.3±5.7)min显著短于对照组的(17.5±7.6)min,差异有统计学意义(P<0.05)。研究组患儿术中不良反应发生率显著低于对照组,两组比较,差异有统计学意义(P<0.05)。结论喉罩麻醉具有心率及呼吸频率较低的特点,麻醉平稳,血氧饱和度高,苏醒期短,不良反应少,可在临床推广应用。
ObjectiveTo investigate the clinical effect of laryngeal mask anesthesia in short-time pediatric surgery. MethodsA total of 60 cases of children planed to receive short-time surgery were randomly divided into study group and control group,30 cases in each group. According to the weight of children, the type of the third generation laryngeal mask were selected in the study group, then the children were given intravenous injection of atropine 0.01 mg/kg, sufentanil 0.25 g/kg and propofol 2 mg/kg respectively;After the disappearance of the throat reflex, jaw relaxation, eyelash reflex disappeared, laryngeal mask were installed. The children of control group were given intramuscular injection of ketamine (4-5 mg/kg) or intravenous injection of ketamine (1-2 mg/kg). The blood pressure, heart rate, respiratory rate, oxyhemoglobin saturation and anesthesia effect of the two groups were observed and compared during the operation. ResultsThe heart rate and respiratory rate of 5 min and 15min in the study group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Compared with the control group, the 5 min and 15 min oxyhemoglobin saturation of the study group was not statistically significant (P>0.05).The highest blood pressure of 5 min and 15 min in the study group were significantly lower than those in the control group, the difference was statistically significant (P<0.05) . The analepsia time of the study group was (10.3±5.7) min,significantly shorter than (17.5±7.6) min of the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group, the difference was statistically significant (P<0.05). ConclusionLaryngeal mask anesthesia has the characteristics of lower heart rate and respiratory rate, smooth anesthesia, high oxyhemoglobin saturation, short analepsia time, less adverse reactions, which can be used in clinical application.