保留自主呼吸喉罩全麻在胸腔镜手术患者中的应用效果

doi:10.20047/j.issn1673-72102023.25.25

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Abstract Objective To explore the application effect of spontaneous ventilation general anesthesia with laryngeal mask in patients for thoracoscopic surgery. Methods Sixty patients undergoing thoracoscopic surgery in Jining No.1 People’s Hospital, Shandong Province from January to June 2022 were selected. They were divided into observation group and control group, with 30 cases in each group. Observation group took spontaneous ventilation general anesthesia with laryngeal mask, and control group took general anesthesia with double-lumen tube. The operation time, mean arterial pressure difference before and after intubation, heart rate difference before and after intubation, intraoperative general anesthetic dosage, minimum pulse oxygen saturation (SpO2), maximum end-tidal carbon dioxide pressure (PetCO2), surgical field exposure score, mediastinal oscillation, and incidence of cough were compared between two groups; arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) before anesthesia (T0), 30 min after thoracotomy (T1), and 30 min after chest closure (T2) were compared between two groups; the time of the postoperative extubation, anesthesia recovery room stay, the first time out of bed, chest tube retention, and postoperative hospitalization were compared between two groups; and the incidence of postoperative anesthesia-related complications and pulmonary complications were compared between two groups. Results Mediastinal oscillation was not observed in the two groups. The mean arterial pressure difference and heart rate difference before and after intubation in observation group were lower than those in control group, the intraoperative dosage of Remifentanil and Sufentanil were lower than those in control group, the maximum PetCO2 and the incidence of cough were higher than those in control group, and the differences were statistically significant (P＜0.05); there were no significant differences in operation time, minimum SpO2, and surgical field exposure score between two groups (P＞0.05). The pairwise comparison of PaO2 between two groups at different time points had statistical significance (P＜0.05). At T1-T2, PaCO2 in control group was higher than that at T0, and the difference was statistically significant (P＜0.05); the pairwise comparison of PaCO2 at different time points in observation group had statistical significance (P＜0.05). At T1, PaCO2 in observation group was higher than that in control group, and the difference was statistically significant (P＜0.05). The time of postoperative extubation, anesthesia recovery room stay, the first time out of bed, chest tube retention, and postoperative hospitalization in observation group were shorter than those in control group, and the differences were statistically significant (P＜0.05). The total incidence of postoperative anesthesia-related complications and pulmonary complications in observation group were lower than those in control group, and the differences were statistically significant (P＜0.05). Conclusion The application of spontaneous ventilation general anesthesia with laryngeal mask in thoracoscopic surgery can alleviate the reaction of intubation during induction, reduce the amount of general anesthesia during operation, reduce postoperative complications and promote rapid recovery.

Key words： Laryngeal mask General anesthesia Spontaneous ventilation Thoracoscopic surgery

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	KONG Xiangang1 WEI Yutao2 LIU Manman1 SONG Chengwei1▲

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KONG Xiangang1 WEI Yutao2 LIU Manman1 SONG Chengwei1▲. Application effect of spontaneous ventilation general anesthesia with laryngeal mask in patients for thoracoscopic surgery[J]. 中国医药导报, 2023, 20(25): 115-119.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-72102023.25.25 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I25/115

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