I-gel喉罩与标准型喉罩用于保留自主呼吸下单孔胸腔镜肺大疱切除术气道管理的比较-东南大学学报医学版

I-gel喉罩与标准型喉罩用于保留自主呼吸下单孔胸腔镜肺大疱切除术气道管理的比较

单位：1. 东南大学医学院附属南京胸科医院麻醉科, 江苏南京 210029;
2. 东南大学医学院附属南京胸科医院胸外科, 江苏南京 210029

分类号：R614.21;R734.2

出版年·卷·期（页码）：2017·36·第三期（449-452）

摘要：

目的：比较I-gel喉罩和标准型喉罩用于保留自主呼吸下单孔胸腔镜肺大疱切除术中气道管理的效果。方法：选择择期行单孔胸腔镜肺大疱切除术患者40例，随机分为I-gel喉罩组（I组）和标准型喉罩组（B组），麻醉诱导后分别置入I-gel喉罩和标准型喉罩；记录两组患者建立通气的时间、首次置入成功率、口咽腔漏气压、健侧卧位纤维支气管镜评级、术中调整喉罩位置例数及术后24 h内相关并发症。结果：与I组比较，B组建立通气时间较长（P<0.05），首次置入成功例数较少（P<0.05），口咽腔漏气压较低（P<0.05）；I组纤维支气管镜评级为Ⅰ级者少于B组（P<0.05）；健侧卧位下I组调整喉罩位置例数少于B组（P<0.05）；术后24 h内咽痛患者I组少于B组（P<0.05）。结论：保留自主呼吸下单孔胸腔镜肺大疱切除术中，I-gel喉罩与标准型喉罩相比气道管理效果更佳，且并发症较少，更加便于气道管理。

Objective:To compare the effect of the I-gel laryngeal mask with the classic laryngeal mask on uni-portal thoracoscopic pulmonary bulla resection under spontaneous ventilation. Methods:A total of 40 patients for elective uni-portal thoracoscopic pulmonary bulla resection were randomly divided into I-gel group(group I)and classic laryngeal mask group(group B).Both laryngeal mask airways were respectively inserted after anesthesia induction.Time and the first success rate of placement, airway leak pressure, levels of airway assessment on lateral position by fiber bronchoscope, frequency of adjust the position of laryngeal mask and postoperative adverse reactions within 24 h were recorded. Results:In group B,the placement time was longer than that of group I(P<0.05);the first success rate was lower than that of group I(P<0.05)and airway leak pressure was higher than that of group I(P<0.05). The number of level I in group I of airway assessment was less than that of group B on lateral position by fiber bronchoscope(P<0.05). Incidence of pharyngalgia in group I was less than that of group B within postoperative 24 h(P<0.05). Conclusion:I-gel might be an effective alternative to classic laryngeal mask and is not associated with adverse events in uni-portal thoracoscopic pulmonary bulla resection under spontaneous ventilation.

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