腰-硬联合麻醉复合喉罩和气管插管全麻在腹腔镜妇科手术的应用比较.docVIP

精品论文 参考文献 腰-硬联合麻醉复合喉罩和气管插管全麻在腹腔镜妇科手术的应用比较 曾亮亮 李桂枝 李伯兴 黄爱儿（东莞市寮步医院麻醉科 广东东莞 523400） 【中图分类号】R714【文献标识码】A【文章编号】1672-5085（2011）41-0200-03 【摘要】目的 观察腰-硬联合麻醉复合喉罩和气管插管全麻对患者血流动力学和术后并发症的影响。方法　择期腹腔镜妇科手术患者60例，随机分为A组和B组。A组选择L2-3间隙进行腰-硬联合麻醉，调整麻醉平面于T6水平，后麻醉诱导插入喉罩。B组为气管插管全麻组。记录麻醉前（T0）、诱导后1min（T1）、插入喉罩或气管导管后1min（T2）、气腹后5min（T3）、拔喉罩或气管导管前（T4）、拔喉罩或气管导管后1min（T5）的SBP、DBP、HR、SpO2和ECG。并记录患者拔管、呼之睁眼、随意运动恢复、定向力恢复的时间，术后疼痛评分。结果 与T0时相比，B组T2、T3、T4、T5时SBP、DBP明显升高，HR明显增快，且相应时点均高于A组（Plt;0.05）；A组拔管时间，睁眼时间，定向力恢复时间明显短于B组，苏醒后述伤口疼痛率，术后咽喉痛A组明显少于B组。结论 腰-硬联合麻醉复合喉罩用于腹腔镜妇科手术具有麻醉效果确切、平稳、苏醒迅速及不良反应少的优点，是较为安全有效的麻醉方法。 【关键词】腰-硬联合麻醉 喉罩 气管插管 腹腔镜妇科手术 Comparison of Combined spinal-epidural anesthesia laryngeal mask airway and endotracheal intubation in the rylaparoscopic gynecological surge under general anesthesia ZENG Liang-liang，Li Gui-zhi，Li Bo-xing，et al. Department of Anesthesiology，Liaobu Hospital，Dongguan 523400，China 【Abstract】 Objective To observe the effects of Combined spinal-epidural anesthesia laryngeal mask airway and endotracheal intubation on hemodynamics and complications. Methods Sixty general anesthesia patients scheduled for selective laparoscopic gynecological surge were randomized into two groups with 30 cases each：A group and B group. Group A choice-3 clearance to waist L2 epidural anesthesia, adjust the anesthesia combined plane in T6 level, narcotic induction into after laryngeal mask. Group B endotracheal intubation for general anesthesia group. Record before anesthesia (T0), after induction 1 min (T1), insert a laryngeal mask or the endotracheal tube after 1 min (T2), gasless laparoscopic after five min (T3), pull out a laryngeal mask or the endotracheal tube (T4), pull out before laryngeal mask or the endotracheal tube after 1 min (T5), the SBP DBP, HR, SpO2 and ECG. And record pull out urinous catheter, called the open and optional sports recovery, directional power recovery time, postoperative pain score. The results and T0 than when group B T2, T3, and T4, T5 SBP and