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目的:观察双管型喉罩用于小儿支气管异物取出术的麻醉效果。方法:选择行支气管异物取出术60例,随机分为双管型喉罩组、气管插管组和面罩组各20例。采用静脉注射丙泊酚2.5～3mg/kg,苯磺顺阿曲库铵0.1～0.2mg/kg,长托宁0.1～0.2mg,地塞米松0.2mg/kg,瑞芬太尼2μg/kg进行麻醉诱导和维持,术中高频喷射呼吸机控制通气。比较3组收缩压(SBP)、舒张压(DBP)、平均压(MAP)、心率(HR)和血氧饱和度(SO2)水平的变化,并观察各组不良反应发生情况。结果:双管型喉罩组SBP、DBP、MAP和HR显著低于气管插管组(P<0.05);HR显著低于面罩组(P<0.05);SO2水平3组间差异不显著(P>0.05)。双管型喉罩组发生咽喉疼痛1例;气管插管组拔出气管导管时发生喉痉挛1例,咽喉疼痛15例;面罩组出现腹胀和托下颌时体动3例;3组均未发生反流和误吸等不良反应。结论:双管型喉罩用于小儿支气管异物取出术中的麻醉效果优于气管插管和面罩。
Objective: To observe the anesthetic effect of double-tube laryngeal mask for removal of bronchial foreign bodies in children. Methods: Sixty cases of bronchial foreign bodies were selected and randomly divided into two groups: intubation group, tracheal intubation group and mask group with 20 cases each. Intravenous injection of propofol 2.5 ~ 3mg / kg, benzene sulphate with atracurium 0.1 ~ 0.2mg / kg, penehyclidine 0.1 ~ 0.2mg, dexamethasone 0.2mg / kg, remifentanil 2μg / kg Anesthesia induction and maintenance, intraoperative high-frequency jet ventilator control ventilation. The changes of SBP, DBP, MAP, HR and SO2 in the three groups were compared. The incidence of adverse reactions in each group was also observed. Results: SBP, DBP, MAP and HR in the double-tube laryngeal mask group were significantly lower than those in the tracheal intubation group (P <0.05); HR was significantly lower than that in the mask group (P <0.05); SO2 level was not significantly different among the three groups > 0.05). 1 case of sore throat occurred in the double-tube laryngeal mask group; 1 case of laryngospasm and throat sore in 1 case of tracheal intubation group, 3 cases of abdominal pain and throat pain in the mask group; 3 cases did not occur in the mask group Reflux and aspiration and other adverse reactions. Conclusions: The dual-tube laryngeal mask is superior to tracheal intubation and face mask in the removal of pediatric bronchial foreign bodies.