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喉罩与气管插管对小儿腹腔镜手术通气和胃内压影响的比较。

Comparison of the effect of LMA and ETT on ventilation and intragastric pressure in pediatric laparoscopic procedures.

机构信息

Department of Anesthesiology and Reanimation, Kocaeli University School of Medicine, Kocaeli, Turkey.

出版信息

Minerva Anestesiol. 2010 Aug;76(8):592-9. Epub 2010 Jun 18.

Abstract

BACKGROUND

The aim of our study was to compare classic laryngeal mask airway (LMA-C) with the endotracheal tube (ETT) in pediatric laparoscopic surgery to evaluate the intragastric pressures (IGP) using intragastric pressure monitoring. We also sought to investigate the related influence on respiratory parameters.

METHODS

The Ethics Committee of the Health Institution approved the study protocol. A total of 40 patients, ASA I-II, three and a half months to 12 years old were included in this randomized study. Two study groups were formed: the ETT group and the LMA-C group. A nasogastric tube was inserted following induction to evacuate any intragastric gas and fluid before application of either LMA-C or ETT. The change in IGP was measured with a transducer, which was attached to the nasogastric tube. IGP, peak airway pressures (PAP), SPO2 and ETCO2 were recorded. Repeated ANOVA measures were used to evaluate the change in IGP, PAP, SPO2 and ETCO2 times in both groups.

RESULTS

The change in IGP was not significant among the groups except at 15 and 30 minutes (P<0.05). The changes in PAP, SPO2, and ETCO2 levels were not significant.

CONCLUSION

The perioperative intragastric pressure evaluation failed to show any significant change in intragastric pressures and ventilation parameters due to the application of LMA-C in this study. We advocate LMA-C application as a feasible anesthetic device in pediatric laparoscopic surgery.

摘要

背景

本研究旨在通过胃内压监测比较小儿腹腔镜手术中经典型喉罩(LMA-C)与气管内导管(ETT)的胃内压(IGP),评估相关呼吸参数的影响。

方法

本研究经医疗机构伦理委员会批准,纳入了 40 名 ASA I-II 级、3.5 个月至 12 岁的患儿,采用随机分组方法分为 ETT 组和 LMA-C 组。诱导后均插入鼻胃管,排空胃内气体和液体,然后应用 LMA-C 或 ETT。通过与鼻胃管相连的换能器测量 IGP 变化,记录 IGP、气道峰压(PAP)、SPO2 和 ETCO2。采用重复方差分析评估两组 IGP、PAP、SPO2 和 ETCO2 时间的变化。

结果

除 15 分钟和 30 分钟外(P<0.05),各组 IGP 变化无统计学意义。PAP、SPO2 和 ETCO2 水平的变化无统计学意义。

结论

本研究中 LMA-C 的应用并未导致胃内压和通气参数发生明显变化,提示围术期胃内压评估失败。我们主张将 LMA-C 作为小儿腹腔镜手术中一种可行的麻醉设备。

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