Poloch A, Romaniuk W, Jałowiecki P, Krawczyk L, Wylegała E, Dyaczyńska-Herman A
Katedry i Kliniki Anestezjologii i Intensywnej Terapii Siaskiej AM-Kliniczny Oddzial Anestezjologii i Intensywnej Terapii, Szpital Górniczy w Sosnowcu.
Klin Oczna. 1996 Jan;98(1):45-9.
This prospective study was designed to compare intraocular pressure changes and haemodynamic response to insertion of either a laryngeal mask or an orotracheal tube during general anaesthesia for cataract surgery.
The effect of techniques (tracheal tube-TT, laryngeal mask airway-LMA) securing a clear upper airway on the heart rate changes (HR), arterial pressure (SAP, DAP), oxygen saturation (SpO2), end-tidal carbon-dioxide pressure (Et-CO2), intraocular pressure (IOP) and the incidence of coughing, stridor and sore throat was analysed in 60 patients undergoing cataract surgery during general anaesthesia.
The mean values for HR, SAP, DAP and IOP measured before and after induction of anaesthesia were not different in both groups. After securing a clear airway, mean HR increased in TT group to 95.5/min and decreased to 75.7/min in LMA group. SAP increased in TT group to 131 mmHg, DAP to 82.6 mmHg, whilst in LMA group both values decreased to 98.6 mmHG and 66.3 mmHg, respectively. The significant difference in IOP values was observed after intubation or using laryngeal mask. In TT group, intraocular pressure increased to 15 mmHg in healthy eye and to 13.6 mmHg in ill eye whilst there was a decrease in LMA group to 5.5 and 7.43 mmHg, respectively. Furthermore, a greater incidence of such complications as coughing, stridor and sore throat in TT group was observed.
The results show that using LMA in microsurgery during general anaesthesia is more advantageous and safer for patients in comparison with tracheal intubation.
本前瞻性研究旨在比较白内障手术全身麻醉期间插入喉罩或气管内导管时的眼压变化和血流动力学反应。
分析了60例全身麻醉下接受白内障手术患者中,确保上呼吸道通畅的技术(气管导管-TT、喉罩气道-LMA)对心率变化(HR)、动脉压(收缩压-SAP、舒张压-DAP)、血氧饱和度(SpO2)、呼气末二氧化碳分压(Et-CO2)、眼压(IOP)以及咳嗽、喘鸣和咽痛发生率的影响。
两组麻醉诱导前后测量的HR、SAP、DAP和IOP平均值无差异。确保气道通畅后,TT组平均HR升至95.5次/分钟,LMA组降至75.7次/分钟。TT组SAP升至131 mmHg,DAP升至82.6 mmHg,而LMA组这两个值分别降至98.6 mmHg和66.3 mmHg。插管或使用喉罩后,IOP值存在显著差异。TT组中,健康眼眼压升至15 mmHg,患眼升至13.6 mmHg,而LMA组分别降至5.5 mmHg和7.43 mmHg。此外,TT组咳嗽、喘鸣和咽痛等并发症的发生率更高。
结果表明,全身麻醉下在显微手术中使用LMA与气管插管相比,对患者更具优势且更安全。