临床小儿外科杂志2025，Vol.24Issue(2)：172-178,7.DOI:10.3760/cma.j.cn101785-202410045-012
喉罩全身麻醉在纤维支气管镜引导下小儿经皮扩张气管切开术的应用
Application of laryngeal mask general anesthesia in pediatric percutaneous dilatational tracheostomy guided by fiberbronchoscope
摘要
Abstract
Objective To explore the efficacy of laryngeal mask general anesthesia during percutaneous dilatational tracheostomy guided by fiberbronchoscope in children.Methods Retrospective analysis of medical records was performed for 40 hospitalized children undergoing percutaneous dilatational tracheostomy at Affilia-ted Children's Hospital of Shandong University from June 2019 to September 2023.Preoperative ultrasonic as-sessment was performed for evaluating thyroid position and following the course of anterior tracheal vessels.This aided in selecting an appropriate puncture route and marking the puncture point.After general anesthesia,a la-ryngeal mask was utilized for respiratory control to ensure ventilation and percutaneous dilatational tracheotomy performed guided by fiberbronchoscope after successful laryngeal mask placement.Statistical analyses were con-ducted for general profiles,anesthesia protocols,ventilation mode,surgical procedures,vital signs and adverse e-vents.Results All procedures were performed smoothly and safely.The average surgical duration was(35±9)min and average anesthesia duration(41±9)min.Laryngeal masks were all successfully placed and pres-sure controlled breathing was achieved with peak inspiratory pressures of(12-20)cmH2O.There was a varia-ble elevation in airway pressure and a slight declined in tidal volume during flexible bronchoscopy.Vital signs remained stable.The incidence of adverse events during perioperative period was 15％.It was primarily attribu-ted to gastrointestinal distension and hypoxemia.Conclusions Pediatric percutaneous dilatational tracheosto-my presents a high risk in terms of perioperative anesthesia management.Laryngeal mask ventilation under gen-eral anesthesia can effectively provide ventilation and maintain a stable depth of anesthesia.This approach en-sures a smooth progression of the procedure while maintaining the stability of vital signs.It enhances the opera-tive safety and is worthy of wider clinical applications.关键词
喉罩/麻醉,全身/纤维支气管镜/经皮扩张气管切开术/儿童Key words
Laryngeal Mask Airway/Anesthesia,General/Fiberbronchoscope/Percutaneous Dilata-tional Tracheostomy/Child引用本文复制引用
王磊,王少超,胡卫东,昝云雷,李全德..喉罩全身麻醉在纤维支气管镜引导下小儿经皮扩张气管切开术的应用[J].临床小儿外科杂志,2025,24(2):172-178,7.基金项目
济南市卫生健康委员会科技计划项目(2023-2-152) Ji'nan Health Commission Science & Technology Plan Project(2023-2-152) （2023-2-152）
