|
|
|
| Application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy |
| HAN lei1 LI yueting2 |
1.Department of Anesthesiology，Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China;
2.Department of General Surgery, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China |
|
|
|
Abstract Objective To investigate the application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy. Methods From August 2016 to August 2018, 64 cases with laparoscopic combined with choledochoscopic choledochoscopy under general anesthesia in Beijing Hospital of Integrated Traditional Chinese and Western Medicine were selected. According to the Excel randomizer, they were randomly divided into I-gel laryngeal mask group (A group) and endotracheal intubation group (B group), with 32 cases in each group. After anesthesia induction, laryngeal mask was placed in group A and endotracheal intubation was performed in group B. The anesthesia time, pneumoperitoneum time and tube extubation time in two groups were compared. The changes of heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in two groups were observed immediately after anesthesia induction (T1), laryngeal mask placement (or intubation) (T2), laryngeal mask placement (or intubation) 3 min (T3), and laryngeal mask placement (or intubation) 10 min(T4). Meanwhile, intubation time, degree of tube tolerance, cough, agitation and pharyngeal pain in two groups were observed. Results There were no significant differences in anesthesia time, pneumoperitoneum time and tube extubation time between two groups (P > 0.05). There were no significant differences in HR, SBP and DBP at each time point in group A (all P > 0.05). HR, SBP and DBP at time points T2, T3 and T4 in group B were all higher than those in group A, and the differences were statistically significant (all P < 0.05). In group B, HR, SBP and DBP at time points T2, T3 and T4 were all higher than T1, and the differences were statistically significant (all P < 0.05). Conclusion I-gel laryngeal mask is used for laparoscopic combined with choledochoscope cholelithotomy under general anesthesia, which is more convenient than endotracheal intubation, more stable hemodynamics and fewer complications. The application effect is safe and reliable.
|
|
|
|
|
|
[1] 薛富善，刘亚洋，李慧娴.困难气道管理策略-目前的问题和将来的方向[J].临床麻醉学杂志，2018，34（1）：89-91.
[2] 井凤云，王军，郭向阳.困难气道评估的临床应用进展[J].中国微创外科杂志，2019，19（4）：363-366.
[3] 王加芳，陈菁，戚忠，等.i-gel喉罩在全麻下经纤维支气管镜气管支架置入术中的应用[J].临床麻醉学杂志，2017， 33（6）：609-610.
[4] Lammert F，Gurusamy K，Ko CW，et al. Gallstones [J]. Nat Rev Dis Primers，2016，28（2）：16 024.
[5] Peng CY，Zou XP. New research and insight on sphincter of oddi dysfunction [J]. Chin J Gastroenterol，2017，22（5）：262-265.
[6] 李太想，史光军.胆石病病因的研究进展[J].临床普外科电子杂志，2018，6（4）：20-24.
[7] 王成，孙培龙.胆石症成因的研究进展[J].肝胆外科杂志，2018，26（2）：157-160.
[8] 刘欢欢，田雨，彭洋，等.胆囊切除术后综合征的诊治和预防[J].临床肝胆病杂志，2018，34（11）：2464-2468.
[9] Wang L，Zhou F，Yan SS，et al. Research progress of gut microbiota dysbiosis after cholecystectomy [J]. Chin J Dig Surg，2018，17（3）：321-324.
[10] 万磊，刘洋，李修良.右美托咪定联合七氟醚吸入诱导用于病态肥胖合并重度鼾症患者喉罩置入的临床观察[J].临床和实验医学杂志，2019，18（6）：664-668.
[11] Li SY， Yao WY， Yuan YJ，et al. SupremeTM laryngeal mask airway use in general Anesthesia for category 2 and 3 Cesarean delivery：a prospective cohort study [J]. BMC Anesthesiol，2017，17（1）：169.
[12] 文光良.喉罩在老年腹腔镜下胆囊切除术患者全身麻醉中的应用效果探讨[J].中国医学前沿杂志：电子版，2016，8（3）：71-74.
[13] 韩万斌.腹腔镜联合胆道镜双镜治疗胆囊结石合并胆总管结石价值分析[J].中国医药科学，2019，9（4）：207-210.
[14] 张和钊，徐钧，底卫东，等.胆总管结石微创外科治疗的现状与进展[J].中国现代医生，2017，55（25）：165-168.
[15] 阿力木江·阿布都热衣木，木沙江·阿布都克力木，斯皮热古丽·阿布都卡地，等.喀什地区维吾尔族胆囊结石患者结石成分和脂代谢特点分析[J].中国医药导报，2018，15（10）：68-71.
[16] 艾则麦提·艾科拜尔，温浩.胆囊结石合并胆总管结石微创诊疗进展[J].医学综述，2018，24（5）：961-965.
[17] 王启晗，张中文，吴健，等.上海地区胆囊结石病的流行病学调查[J].外科理论与实践，2018，23（3）：252-257.
[18] 汪翠芸，吴绍钦，张超，等.微创保胆取石术的临床研究[J].中外医学研究，2017，15（29）：28-30.
[19] 朱星屹.内镜微创保胆手术治疗胆囊良性疾病专家共识（2018版）[J].中国内镜杂志，2018，24（9）：106-112.
[20] 李爱华.中西医结合护理在胆道镜微创保胆取石术围手术期中的应用分析[J].中外医学研究，2019，17（17）：115-117.
[21] 刘京山.内镜微创保胆手术指南（2015版）[J].中国内镜杂志，2016，22（8）：111-112.
[22] 王霆，吴亚谋，杨卫国，等.一次性双腔无囊喉罩I-gel在烧伤手术麻醉中的应用[J].安徽医药，2018，22（7）：1360-1363.
[23] 陈坤明，丛仔红.I-gel和Supreme型喉罩在预测重度困难气道管理中的应用研究[J].中国临床医生杂志，2016， 44（6）：31-34.
[24] 车国卫，吴齐飞，邱源，等.多学科围手术期气道管理中国专家共识（2018版）[J].中国胸心血管外科临床杂志，2018，25（7）：545-549.
[25] 盛柳芳，俞盛辉，胡建雷，等.比较喉罩或气管插管全麻对老年患者术后肺部感染的影响[J].中华医院感染学杂志，2018，28（23）：3586-3589.
[26] 陈亮，何文胜，张军，等.右美托咪定对I-gel喉罩通气下气管支架置入术中血流动力学的影响[J].临床麻醉学杂志，2016，32（12）：1226-1227. |
|
|
|
