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喉罩通气道与气管导管在低流量麻醉控制通气下术后并发症的比较。

Comparison of postoperative complication between Laryngeal Mask Airway and endotracheal tube during low-flow anesthesia with controlled ventilation.

机构信息

Ali Peirovifar, Associate Professor of Anesthesiology, Fellowship of Critical Care Medicine, Faculty of Medicine, Anesthesiology Research Team, Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.

Mahmood Eydi, Associate Professor of Anesthesiology, Faculty of Medicine, Anesthesiology Research Team, Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Pak J Med Sci. 2013 Apr;29(2):601-5. doi: 10.12669/pjms.292.2980.

Abstract

OBJECTIVE

To compare the postoperative complications between Laryngeal Mask Airway (LMA) and endotracheal tube (ETT) during low-flow anesthesia with controlled ventilation.

METHODOLOGY

Eighty adult Patients with ASA class I or II were randomly allocated into two forty-patient groups (ETT or LMA). Cuff pressure was monitored during anesthesia. After high uptake period, fresh gas flow (FGF) was decreased to 1 lit/min and isoflurane set to 1%. Monitoring during anesthesia included non-invasive blood pressure, ECG, ETCO2 and pulse oximetry. System leakage (>100 ml/min), rebreathing and any attempt to increase FGF to overcome the leak were monitored during anesthesia. Later, patients were extubated and transferred to Post Anesthesia Care Unit (PACU). In PACU, the incidence of sore throat, cough, difficulty in swallowing and shivering was monitored for all patients.

RESULTS

Leakage was observed in two and three cases in ETT and LMA groups respectively (P>0.05). Postoperative cough, sore throat and difficulty in swallowing were significantly less in LMA than ETT group. No significant difference was observed regarding ETCo2 values between 2 groups.

CONCLUSION

If careful measures regarding insertion techniques, correct LMA position and routine monitoring of LMA cuff pressure are taken, LMA can be used as a safe alternative with lower incidence of post operation complication compared with ETT during low-flow controlled anesthesia with modern anesthetic machines.

摘要

目的

比较低流量麻醉控制通气时喉罩气道(LMA)与气管内导管(ETT)的术后并发症。

方法

80 例 ASA 分级 I 或 II 级的成年患者被随机分为两组,每组 40 例(ETT 或 LMA)。监测麻醉期间的套囊压力。高摄取期后,将新鲜气体流量(FGF)降低至 1 升/分钟,并将异氟醚设置为 1%。麻醉期间监测包括无创血压、心电图、ETCO2 和脉搏血氧饱和度。监测麻醉期间的系统泄漏(>100ml/min)、再呼吸和任何试图增加 FGF 以克服泄漏的尝试。随后,患者拔管并转移至麻醉后恢复室(PACU)。在 PACU 中,监测所有患者的咽痛、咳嗽、吞咽困难和寒战的发生率。

结果

ETT 和 LMA 组分别有 2 例和 3 例发生泄漏(P>0.05)。LMA 组术后咳嗽、咽痛和吞咽困难的发生率明显低于 ETT 组。两组 ETCo2 值无显著差异。

结论

如果采取谨慎的插入技术措施、正确的 LMA 位置和常规监测 LMA 套囊压力,与现代麻醉机的低流量控制麻醉相比,LMA 可作为一种安全的替代方法,术后并发症发生率较低。

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