目的 探索免充气型喉上通气道(SLIPA)喉罩在不同年龄患者膀胱镜手术中应用的安全性及有效性。方法 选择2019-9至2019-11解放军总医院第一医学中心行膀胱镜手术患者100例,分为老年组(n=50)与非老年组(n=50)。比较两组患者不同时间点时平均血压(MBP)、心率(HR)以及喉罩漏气、更换喉罩、喉罩染血及术后咽痛、声嘶的发生情况。结果 老年组和非老年组患者使用SLIPA喉罩的即时MBP[ 插入时(87.8±11.7)mmHg vs.(87.2±13.6)mmHg;拔除后(94.0±10.8)mmHg vs.(89.2±14.9)mmHg ]和即时HR[插入时(65.0±9.88)次/min vs.(72.5±12.4)次/min;拔出时(76.4±10.0)次/min vs.(81.6±9.39)次/min] 差异无统计学意义(P>0.05);两组患者喉罩漏气情况、拔除喉罩后声嘶、染血、咽痛进行对比差异无统计学意义(P>0.05);老年组8例患者经3次及以上的尝试后才成功插入喉罩,3次及以上的尝试率较非老年组高(16% vs. 0%),差异有统计学意义(P<0.05)。结论 SLIPA喉罩适用于不同年龄患者膀胱镜手术全麻中的气道管理,可降低插管和拔管过程中强烈的应激反应。
Abstract
Objective To explore the safety and effectiveness of streamlined liner of pharyngeal airway (SLIPA) laryngeal mask in cystoscopy for patients of different ages.Methods A total of 100 patients undergoing cystoscopy in PLA General Hospital from September 2019 to November 2019 were selected and divided into the elderly group (n=50) and the non-elderly group (n=50).Average blood pressure (MBP), heart rate (HR), laryngeal mask leakage, replacement of laryngeal mask, blood contamination of laryngeal mask, postoperative pharyngeal pain and hoarseness were compared between the two groups at different time points.Results There were no significant difference of the immediate MBP [at insertion: (87.8±11.7) mmHg vs. (87.2±13.6) mmHg; after extraction: (94.0±10.8) mmHg vs. (89.2±14.9) mmHg)] and the immediate HR [at insertion:(65.0±9.88) bpm vs. (72.5±12.4) 次/min; after extraction: (76.4±10.0) bpm vs. (81.6±9.39) 次/min] between the elderly and non-elderly groups with SLIPA laryngeal mask (P>0.05). There was no significant difference in air leakage, hoarseness, blood stain and sore throat between the two groups (P>0.05).The laryngeal mask was successfully inserted in 8 patients in the elderly group after 3 or more attempts, the rate of 3 or more attempts was higher than that in the non-elderly group (16% vs. 0%), and the difference was statistically significant (P<0.05).Conclusion SLIPA laryngeal mask is suitable for airway management under general anesthesia in cystoscopic surgery in patients of different ages, and it can reduce the strong stress response during intubation and extubation.
关键词
SLIPA喉罩 /
全身麻醉 /
气道管理 /
膀胱镜手术
Key words
SLIPA laryngeal mask /
general anesthesia /
airway management /
cystoscopic surgery
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参考文献
[1] Modir H, Moshiri E, Yazdi B, et al. Comparing the efficacy and safety of laryngeal mask airway, streamlined liner of the pharyngeal airway and I-gel following tracheal extubation[J]. Med Gas Res, 2017, 7(4):241-246.
[2] Liu Z, Yang R, Sun Y. Nonintubated uniportal thoracoscopic thymectomy with laryngeal mask [J].Thorac Cardiovasc Surg, 2020, 68(5):450-456.
[3] Koyama T, Kobayashi M, Ichikawa T, et al. Laryngeal mask versus facemask in the respiratory management during catheter ablation [J]. BMC Anesthesiol, 2020,20(1):9.
[4] Hegde H V, Bandi J, Mudakanagoudar M S, et al. Evaluation of performance of streamlinedliner of the pharynx airway, laryngeal mask airway-proseal and endotracheal tube in prone position: a prospective, randomised study [J]. Indian J Anaesth, 2018, 62(3):173-181.
[5] Chen Y, Bai J, Wang R. Insertion methods comparison for the streamlined liner of the pharynx airway in children by novice [J]. Acta Anaesthesiol Scand, 2018, 62(3):319-327.
[6] Hinkelbein J, Schmitz J, Mathes A, et al. Performance of the laryngeal tube for airway management during cardiopulmonary resuscitation [J]. Minerva Anestesiol, 2021, 87(5):580-590.
[7] Cottrell J E, Hartung J.Anesthesia and cognitive outcome in elderly patients: a narrative viewpoint [J].Neurosurg Anesthesiol,2020, 32(1):9-17.
[8] 严 峰, 李 军, 王浩杰, 等.三种方法定位喉罩在老年全麻患者气道管理中的对比研究[J].中华医学杂志, 2018, 98(18):1424-1429.
[9] 黄巧文, 林志坚, 陆志伟, 等. 喉罩在非常规手术麻醉应用的新进展[J].麻醉安全与质控, 2021,59(3).
[10] Zhong H Y, Deng X B, Wang Z. Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial[J]. J Pain Res, 2018, 11:2821-2826.
[11] Ozhan M O, Eskin. Laryngeal mask airway for general anesthesia in interventional neuroradiology procedures[J].Saudi Med J, 2019,40(5):463-468.
[12] Geng G, Chen Y, Liu H. Preheating of streamlined liner of pharyngeal airway (SLIPA) reduced the related complications: a randomized control study[J].J Clin Monit Comput, 2017, 31(3):547-550.
[13] 王丽红, 全虎杰, 宋相宇, 等. SLIPA喉罩置入对腹腔镜妇科手术患者心血管应激反应的影响研究[J]. 航空航天医学杂志, 2018, 29(2):185-187.
[14] 余云兰, 黄莉莉, 林加福, 等. 三种麻醉方式在高龄患者人工股骨头置换术中的效果分析[J]. 创伤外科杂志, 2021, 23(6):465-467+471.
[15] 丁雪娇,史亮解,温品吕,等.喉罩麻醉与气管插管麻醉在硬膜外麻醉不全患者中的比较分析[J]. 海军医学杂志, 2021, 42(3):310-313, 339.
[16] 谷广锋, 沈海检, 李旭东, 等. SLIPA喉罩与气管插管麻醉在老年全身麻醉下行腹腔镜手术患者中的应用效果分析[J].中国医学工程, 2019, 27(7):90-92.
[17] 刘 亮, 渠艳霞,本少杰. SLIPA喉罩对隆乳术全身麻醉患者麻醉效果及应激反应的影响[J]. 实用临床医学, 2020, 21(12):27-29.
[18] Jannu A, Shekar A, Balakrishna R, et al.Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask[J]. Arch Craniofac Surg, 2017, 18(4):223-229.
[19] 张雨洁,毛文虹,高 颖,等. SLIPA喉罩与Supreme喉罩的临床应用对比[J].国际呼吸杂志, 2020, 40(20):1580-1584.
[20] 姜 姗, 刘 毅.新型卡尺指导SLIPA喉罩型号选择准确性研究[J].医疗卫生装备, 2018, 39:60-63.
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