【作者】 杨冯睿；

【导师】 蒋宗滨；

【作者基本信息】 广西医科大学 ， 麻醉学， 2009， 硕士

【摘要】 [目的]探讨欧普乐喉罩在腹腔镜精索静脉高位结扎术中应用的可行性和安全性,并观察欧普乐喉罩与经典喉罩比较的优缺点。[方法]择期腹腔镜精索静脉高位结扎手术患者60例,随机分为气管插管组、经典喉罩组和欧普乐喉罩组,每组20例。观察记录3组患者麻醉前(T1 )、喉罩或气管导管置入前(T2)、置入即刻(T3)、置入后3 min(T4)、气腹前即刻(T5)、气腹后10min(T6)、恢复自主呼吸时(T7)、拔除即刻(T8)、拔除后10min(T9)的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2) ,气腹前后和体位变化前后的气道峰压(Pmax)、气道平均压(Pmex)、呼吸末二氧化碳分压(PETCO2),插入时间、置入次数、术中漏气情况,并记录各组术中和术后的相关并发症:心动过速,高血压,苏醒期躁动,咽喉不适,恶心呕吐,呃逆。[结果]经典喉罩组和欧普乐喉罩组在置入期、恢复自主呼吸时和拔除期HR、MAP的变化较气管插管组小(P <0.05);3组术中的Pmax、PETCO2均易受手术气腹的影响(P <0.05),但3组比较差异无统计学意义(P>0.05);3组各观察时点的SpO2比较无统计学意义(P >0.05);欧普乐喉罩组插入时间要短于经典喉罩组和气管插管组(P <0.05);经典喉罩组和欧普乐喉罩组患者术中和术后并发症少于气管插管组(P<0.05)。[结论]欧普乐喉罩与气管插管相比且具有操作简便、应激反应小、并发症少的优点;欧普乐喉罩与经典喉罩相比具有插入简单迅速的优点;欧普乐喉罩可安全、有效的用于腹腔镜精索静脉高位结扎术的麻醉。更多还原

【Abstract】 Objective To observe the feasibility and the safety of application of Oro-Pharyngeal airway Cap and classic LMA in laparoscopic varicocelectomy,and the characteristics of OPLAC compared to classic LMA.Methods Sixty ASA I-II patients, scheduled for laparoscopic varicocelectomy were randomly assigned to ET group(n=20)、classic LMA group(n=20)and OPLAC group(n=20). After standard intravenous anesthetic induction, insertion of OPLAC、classic LMA and ET was performed. MAP, HR and SpO2 were recorded before anesthesia induction(T1) ,before intubation(T2) ,after intubation immediately(T3) ,at 3 min after intubation(T4), before CO2 pneumoperitoneum(T5 ),at 10 min after CO2 pneumoperitoneum(T6),the moment of respiratory restoration(T7), after extubation immediately(T8), 10 min after extubation(T9); implantation time、frequency of placement、number of intraoperative leakage and pertinent side-effects(tachycardia, hypertension, restlessness during recovery, throat discomfort, nausea and vomiting, hiccup) were monitored and recorded. Results In group ET, MAP、HR were significantly higher than those in group classic LMA and group OPLAC at implantation period、the resumption of spontaneous breathing period and removal period(P〈0.05);In there groups ,Pmax、PETCO2 were easily affected by pneumoperitoneum(P〈0.05),but there is no difference between the there groups(P >0.05) ;In all observe periods,there is no SpO2 difference between the two groups(P>0.05); In group OPLAC, the insertion time were shorter than those in group classic LMA and group ET(P〈0.05);In group ET, intraoperative and postoperative complications were significantly higher than those in group classic LMA and group OPLAC(P〈0.05).Conclusion Compared with ET use in laparoscopic varicocelectomy, OPLAC is simple use、have less stress reaction、have less complications; Compared with classic LMA of insertion, OPLAC is more simple and fast ;OPLAC can be safely and effectively used in laparoscopic varicocelectomy.更多还原