实用医学杂志2017，Vol.33Issue(3)：455-458,4.DOI:10.3969/j.issn.1006-5725.2017.03.033
喉罩全麻和气管插管全麻在单孔胸腔镜肺叶切除术中的临床对照研究
Comparison of laryngeal mask anesthesia and intubation anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery
张洪江 1潘维敏 1张林 1温翠丽1
作者信息
- 1. 266000 青岛大学附属医院黄岛院区麻醉科
- 折叠
摘要
Abstract
Objective To assess the feasibility of laryngeal mask anesthesia under spontaneous ventilation in pulmonary resection with uniportal video-assisted thoracoseopic.Methods Forty patients with pulmonary masses were randomized into two groups(n =20 in each group) to undergo pulmonary resection with uniportal videoassisted thoracoscopic,full implementation of thoracoscopic lobectomy and mediastinal lymph node dissection.Patients in two groups were induced by intravenous anesthesia,and the skin of the fifth intercostal space were infiltrated with ropivacaine.Patients in two both groups were maintained by intravenous ancsthesia and sevoflurane anesthesia.Muscle relaxants were administered in endotracheal inmbation group but not in the LMA group.Patients in the LMA group and tracheal intubation group underwent with spontaneous breathing and one-lung ventilation respectively.Results No significant differences were found in surgery time,intraoperative lowest SpO2,preoperative PaCO2,1-h postoperative blood gas analysis between the two groups.The anesthesia induction time,extubation time,and the stay time for the recovery of anesthesia and postoperative hospital stay were significantly shorter than those in the tracheal intubation group.The increments in MAP and HR after intubation operation were smaller than those in the LMA group.The total dosage of sulfentanyl and propofol per kg in the LMA group were significantly less than those in the control group.The PaCO2 after pulmonary resection and the intraoperative maximum level of PETCO2 in the former group were significantly higher than those in the tracheal intubation group,however the incidence of throat discomfort and the hospitalization cast were significantly decreased.Conclusion In view of patient rehabilitation and in hospitalization cast,laryngeal mask anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery was better than the procedure performed under intubation anesthesia.关键词
自主呼吸/喉罩/双腔支气管插管/单孔胸腔镜/肺叶切除Key words
Spontaneous breathing/Laryngeal mask airway/Endotracheal intubation/Uniportal video-assisted thoracoscopic/Pulmonary resection引用本文复制引用
张洪江,潘维敏,张林,温翠丽..喉罩全麻和气管插管全麻在单孔胸腔镜肺叶切除术中的临床对照研究[J].实用医学杂志,2017,33(3):455-458,4.
