摘要
目的比较SLIPA喉罩和气管插管麻醉对老年腹腔镜手术患者全麻诱导期的血流动力学和应激激素的影响。方法选择择期全麻下腹腔镜手术患者80例,随机分为T组与S组。T组给予气管插管,S组给予喉罩置入麻醉。观察并比较两组患者在麻醉诱导前1min(T0)、插管或置入喉罩后即刻(T1)、插管或置入喉罩后1min(T2)、插管或置入喉罩后3 min(T3)、插管或置入喉罩后5 min(T4)各时间点的心率(HR)、平均动脉压(MAP)、指脉氧(SpO2)、去甲肾上腺素(NE)、肾上腺素(E)及皮质醇(Cor)的变化情况。结果两组患者在T0时HR、MAP、SpO2、NE、E及Cor的差异无统计学意义(P>0.05)。与T0比较,T组患者T1、T2、T3及T4时间点的HR、MAP明显升高(P<0.05),T1和T2时间点的SpO2明显降低(P<0.05);S组患者T2时间点的HR明显升高(P<0.05),T1和T2时间点的MAP明显升高(P<0.05),其余指标未见明显变化(P>0.05)。相同时间点比较时,T组HR、MAP的升高程度明显高于S组(P<0.05);但两组患者麻醉过程中SpO2的差异无统计学意义(P>0.05)。T组患者在T1、T2、T3各时间点的NE、E、Cor的浓度均高于同组T0(P<0.05),S组患者仅在T3时间点的E、Cor高于同组T0(P<0.05)。两组患者NE、E、Cor水平在T1、T2、T3时间点有统计学差异(P<0.05),但在T4时间点无统计学差异(P>0.05)。结论喉罩麻醉应用于老年腹腔镜全麻手术患者,有利于维持诱导期血流动力学稳定,减小应激反应。
Objective To compare theeffects of SLIPA and endotrachealintubation on hemodynamics and stress hormone ingeneral anesthesia induction of elderly laparoscopic operation.Methods 80 cases of elderly laparoscopic patients were included and randomly divided into 2groups,with 40 cases in each group.The T group was treated with endotracheal intubation,while the S group received SLIPA laryngeal mask.The heart rate（HR）,mean arterial pressure（MAP）,pulse oxygen saturation（SpO2）,Norepinephrine（NE）,Epinephrine（E）and cortisol（Cor）were T3 detected and compared at the following 5time points:1min before anesthesia induction（T0）as well as immediately（T1）,1min（T2）,3min（T3）and 5min（T4）after SLIPA laryngeal mask insertion or endotracheal intubationafter anesthesiainduction.Results There were no differences in hemodynamics and stress hormone before anesthesia（P>0.05）.The HR and MAP were all significantly increased after endotracheal intubation in T group（P<0.05）.There was a significant difference between 2groups in HR and MAP at T1,T2,T3（P<0.05）,but they came to the same at T4（P>0.05）.There was no difference between 2groups in SpO2 after anesthesia induction（P>0.05）.The NE,E and Cor were all significantly increased in T group（P<0.05）,which was significant different from S group（P<0.05）.Conclusion Compared with endotracheal intubation,SLIPA laryngeal mask ventilation is better in maintainingthe stability of hemodynamics,and minishingstressresponse when applied to general anesthesia induction in elderly laparoscopic operation.
出处
《中国实验诊断学》
2016年第8期1278-1281,共4页
Chinese Journal of Laboratory Diagnosis
关键词
SLIPA喉罩
气管插管
腹腔镜
血流动力学
应激
SLIPA laryngeal mask
endotracheal intubation
laparoscopic operation
hemodynamics
stress
