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发育障碍牙科护理患者的全身麻醉:加强型喉罩气道与气管插管麻醉的比较

General anesthesia for developmentally disabled dental care patients: a comparison of reinforced laryngeal mask airway and endotracheal intubation anesthesia.

作者信息

Hung Wei-Te, Hsu Shih-Che, Kao Chai-Tze

机构信息

Department of Anesthesiology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

Spec Care Dentist. 2003 Jul-Aug;23(4):135-8. doi: 10.1111/j.1754-4505.2003.tb00299.x.

Abstract

Providing dental care for developmentally disabled patients who require general anesthesia is challenging for both and dentists and anesthesiologists. This study aimed to compare the efficacy of two anesthetic methods for dental care. The researchers retrospectively analyzed morbidity data following anesthesia using either a reinforced laryngeal mask airway (LMA) or endotracheal intubation anesthesia for a two-year time period. The subjects were developmentally disabled patients receiving dental care. Statistical analyses were by unpaired student t-tests and chi-square tests. Patients were who anesthetized with a reinforced laryngeal mask airway had a significantly shorter recovery period and lower postanesthetic complication rates when compared to patients undergoing endotracheal intubation anesthesia. Although hypoxemia (SPO2 < 90%) during dental care occurred more frequently when using the reinforced laryngeal mask airway, the difference was not significant. Nausea and vomiting were the major complications in the postanesthetic care unit and after discharge. When complication rates were compared in the two patient groups, nausea and vomiting were significantly higher during postanesthetic care and after discharge in the intubated group. In conclusion, reinforced laryngeal mask airway provides general anesthesia with less risk of side effects for developmentally disabled patients undergoing dental care.

摘要

为需要全身麻醉的发育障碍患者提供牙科护理,对牙医和麻醉医生来说都是一项挑战。本研究旨在比较两种麻醉方法用于牙科护理的效果。研究人员回顾性分析了在两年时间内,使用加强型喉罩气道(LMA)或气管插管麻醉进行麻醉后的发病率数据。研究对象为接受牙科护理的发育障碍患者。采用非配对学生t检验和卡方检验进行统计分析。与接受气管插管麻醉的患者相比,使用加强型喉罩气道麻醉的患者恢复期明显更短,麻醉后并发症发生率更低。虽然在牙科护理期间使用加强型喉罩气道时低氧血症(SPO2<90%)更频繁发生,但差异不显著。恶心和呕吐是麻醉后护理单元和出院后的主要并发症。比较两组患者的并发症发生率时,插管组在麻醉后护理期间和出院后恶心和呕吐明显更高。总之,加强型喉罩气道为接受牙科护理的发育障碍患者提供全身麻醉时副作用风险更低。

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