气管插管全麻与喉罩全麻用于腹腔镜胆囊切除患者麻醉效果的观察

doi:10.3969/j.issn.1006-6233.2022.05.07

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Abstract Objective: To study the effect of general anesthesia with laryngeal mask versus general anesthesia with tracheal intubation in patients with laparoscopic cholecystectomy and the influence on hemodynamics. Methods: A total of 60 patients undergoing laparoscopic cholecystectomy in our hospital were selected and randomly divided into a laryngeal mask general anesthesia group and an tracheal intubation general anesthesia group, 30 cases in each.The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), blood oxygen saturation (SpO2), electroencephalographic bispectral index (BIS), and the dose of atracurium and isoproterenol were observed at the time points before induction of anesthesia (T0), before laryngeal mask and tracheal intubation placement after induction (T1), at the time of laryngeal mask and tracheal intubation placement (T2), at the time of laparoscopic placement (T3), at 30 min into the operation (T4), and when the preoperative modified sedation and wakefulness score (OAA/S) was ≥4 (T5) in the two groups. The doses of atracurium and isoproterenol were also observed, as well as the patient's response and post-anesthesia wakefulness time during removal of the mask and tracheal intubation in both groups. Results: The satisfaction rate of anesthesia in the laryngeal mask group was 90.00%, which was significantly higher than that in the tracheal intubation group, which was 73.33% (χ²=9.815, P<0.05). The doses of propofol and atracurium in the laryngeal mask group were significantly lower than those in the tracheal intubation group (t=2.177, 4.162, P<0.05); the awakening time of the patients in the laryngeal mask group was significantly shorter than that in the tracheal intubation group, and the incidence of somatic choking reaction was significantly lower than that in the tracheal intubation group (t/χ²=3.175, 6.812 , P<0.05); the levels of SBP, DBP and HR in the laryngeal mask group at time points T2 and T4 were significantly lower than those in the tracheal intubation group (P<0.05), but there was no significant difference in the BIS values between the two groups at each time point (P>0.05). Conclusion: The use of laryngeal mask general anesthesia in laparoscopic cholecystectomy can effectively reduce the dosage of anesthetic drugs, and the patient's blood flow is more stable than that of tracheal intubation patients under general anesthesia, and the patients wake up quickly after surgery. It is worthy of clinical application.

Key words： General anesthesia with laryngeal mask General anesthesia with tracheal intubation Cholecystectomy EEG bispectral index

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.05.07 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I5/736

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