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目的探讨小儿喉罩麻醉保留自主呼吸在全麻术中的应用效果。方法抽取2016年1-12月医院收治的择期行全麻手术患儿50例,50例患儿均应用小儿喉罩麻醉保留自主呼吸实施全麻术进行治疗,记录患儿麻醉诱导前、放置小儿喉罩后的血氧饱和度(Sp O2)、血流动力学、呼吸末二氧化碳(PETCO2)变化情况。结果 50例患儿均保留自主呼吸行盲探置管,其中48例患儿一次置管成功,2例患儿二次置管成功。50例患儿均未见反流、误吸、恶心、呕吐等不良反应。50例患儿置入喉罩后即刻的Sp O2明显较置入喉罩前高,差异有统计学意义(P<0.05);但术中保留自主呼吸时患儿的Sp O2一直处在较为稳定的状态,且患儿术中的PETCO2也均未发生较为明显的波动,差异均无统计学意义(P>0.05)。50例患儿置入喉罩后即刻的HR、SBP、DBP等血流动力学指标均低于置入喉罩前,差异均有统计学意义(P<0.05);但置入喉罩后患儿的HR、SBP、DBP等血流动力学指标一直处在一个较为稳定的状态,未发生较为明显的波动,差异无统计学意义(P>0.05)。结论应用小儿喉罩实施全麻术中保留自主呼吸可实现患儿术中血流动力学稳定,有效改善术中缺氧、二氧化碳蓄积等问题的应用效果,从而取得良好的麻醉效果。
Objective To investigate the effect of pediatric laryngeal mask anesthesia on spontaneous breathing in general anesthesia. Methods Fifty children undergoing general anesthesia undergoing elective operation from January to December 2016 were enrolled in this study. Fifty children were treated with general anesthesia with pediatric laryngeal mask anesthesia and spontaneous breathing, and children were placed before anesthesia induction SpO2 oxygen saturation (Sp O2), hemodynamics, end-tidal carbon dioxide (PETCO2) changes. Results All the 50 children underwent spontaneous breathing blind catheterization, of which 48 were successful in one catheterization and 2 were successful in the second catheterization. None of the 50 children had any adverse reactions such as reflux, aspiration, nausea and vomiting. The Sp O2 immediately after laryngeal mask placement in 50 patients was significantly higher than that before laryngeal mask placement (P <0.05). However, Sp O2 remained relatively stable during spontaneous respiration , And there was no obvious fluctuation in PETCO2 in children with the difference between the two groups (P> 0.05). The hemodynamic indexes of HR, SBP and DBP immediately after laryngeal mask placement in 50 cases were lower than those before laryngeal mask placement (P <0.05). However, Children’s HR, SBP, DBP and other hemodynamic parameters have been in a more stable state, there was no obvious fluctuations, the difference was not statistically significant (P> 0.05). Conclusion The application of pediatric laryngeal mask to maintain spontaneous breathing during general anesthesia can achieve satisfactory hemodynamic stability during operation, effectively improve the intraoperative hypoxia and carbon dioxide accumulation, and achieve good anesthetic effects.