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

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) 屮图分类号】R714 】A 】1672-5085 (2011) 41-0200-03 】A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。记荥麻醉前(T0)、诱导后lmin (T1)、 插入喉罩或气管导管后lmin(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lmin (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，苏醒后述伤门疼痛率，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 (TO), after induction 1 min (Tl), 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 TO than when group B T2, T3, and T4, T5 SBP and DBP when increased significan