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目的:与传统的气管插管(TT)方法作比较,探讨喉罩(LMA)在小儿先天性心脏病介入治疗术麻醉中的应用效果。方法:选择美国麻醉师协会(ASA)评分Ⅰ～Ⅱ级,先天性心脏病介入治疗的患儿60例,随机分为2组:喉罩组(LMA组,30例)和气管插管组(TT组,30例)。LMA组全麻诱导静脉给予丙泊酚1.5 mg/kg和雷米芬太尼2μg/kg,在药物完全起效后行LMA置入。TT组全麻诱导时加用肌松药罗库溴铵0.6 mg/kg。麻醉维持采用丙泊酚和雷米芬太尼持续输注。分别记录两组患儿手术时间、苏醒时间、麻醉诱导前、LMA或TT置入前、置入后以及拔除前、后的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的数值,并对置入LMA或TT的一次成功率进行比较,监测术毕麻醉恢复情况。结果:两组患儿手术时间、苏醒时间、麻醉诱导前及LMA或TT置入前、拔除前的MAP、HR、SpO2值相比较无统计学差异(P>0.05),而在置入后和术后拔除LMA或TT时LMA组的MAP、HR低于TT组(P<0.05),术后呼吸系统并发症LMA组少于TT组(P<0.05)。结论:喉罩下全身麻醉用于小儿先天性心脏病介入治疗,与气管插管全麻相比,患儿血流动力学平稳,术后呼吸系统并发症少。
Objective: To compare the effect of tracheal intubation (TT) with tracheal intubation (TT) in treating anesthesia of LMA in pediatric patients with congenital heart disease. Methods: Sixty ASA children were randomly divided into two groups: laryngeal mask group (LMA group, 30 cases) and endotracheal intubation group (control group) TT group, 30 cases). LMA anesthesia induced by intravenous propofol 1.5 mg / kg and remifentanil 2μg / kg, the drug was fully LMA after the onset of action. TT group induction of general anesthesia with rocuronium loracurium 0.6 mg / kg. Anesthesia was maintained with continuous infusion of propofol and remifentanil. The mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) before and after LMA or TT implantation, recovery time, anesthesia induction, ), And the success rate of one-time LMA or TT was compared to monitor the recovery of anesthesia after operation. Results: There was no significant difference in MAP, HR and SpO2 before and after surgery between two groups in terms of operation time, recovery time, before induction of anesthesia and before LMA or TT insertion (P> 0.05) MAP and HR in LMA group were lower than those in TT group (P <0.05) after LMA or TT was removed. Respiratory complications were less in LMA group than in TT group (P <0.05). Conclusion: Under the mask of general anesthesia for children with congenital heart disease interventional treatment, compared with general anesthesia tracheal intubation, hemodynamics in children with stable postoperative respiratory complications less.