ProSeal喉罩在腹腔镜手术的运用(1)
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【摘要】 目的：听觉诱发电位指数是监测麻醉深度的一项新指标，ProSeal喉罩是一种新型通气喉罩。本实验探讨腹腔镜胆囊切除术的两种麻醉通气法中听觉诱发电位与传统监测指标的优异。方法：100例择期腹腔镜胆囊切除术患者随机分为ProSeal喉罩组与气管插管组。在全麻诱导插管期比较两组中听觉诱发电位指数，血糖，平均动脉压，心率的变化。结果：两组中听觉诱发电位指数在麻醉诱导期差异无统计学意义，但在插管期ProSeal喉罩组听觉诱发电位指数比气管插管组更平稳。两组中血糖、平均动脉压、心率也有类似变化。结论：ProSeal喉罩能减轻全麻插管的应激反应，听觉诱发电位指数比传统监测指标能更好地反应插管应激。
【关键词】 听觉诱发电位指数； 应激反应； 腹腔镜胆囊切除术
Comparison of Two Different Airway Devices for Laparoscopic Cholecystectomy/FENG Chang-sheng， CHEN Bing， YANG Xiao-lin， et al.//Medical Innovation of China，2012，9(9):3-5
【Abstract】 Objective：A-Line ARX IndexTM(AAI) is a new parameter to monitor the depth of anesthesia and ProSeal LMA (laryngeal mask airway)is a new laryngeal mask airway for ventilation. This study is designed to investigate the stress response with different parameters during anesthesia induction and intubation to compare the outcomes produced by ProSeal laryngeal mask airway(PLMA) and endotracheal tube(ETT) respectively used for laparoscopic cholecystectomy. Methods： One hundred selected patients for laparoscopic cholecystectomy(LC) were randomly devided into two groups(PLMA group and ETT group)， an identical general anesthesia technique was used in all patients. The primary outcome measure was AAI. Secondary outcome measures included blood glucose(BG)， mean arterial pressure(MAP)， heart rate(HR). Results： There was no statistical difference in AAI between the PLMA group and the ETT group during anesthesia induction， but AAI maintained more stable in the PLMA group than the ETT group during airway insertion. There was a similarity among BG， MAP， and HR between the two groups. Conclusion： These results suggest that the usage of PLMA can attenuate the stress response in general anesthesia and AAI is as good as traditional parameters to reflect the stress response.
【Key words】 AAI; Stress Response; Laparoscopic cholecystectomy
First-author’s address: North Sichuan Medical College Affiliated Hospital， Nanchong 637000， China
doi:10.3969/j.issn.1674-4985.2012.09.002
1983年Brain发明了喉罩——第一代喉罩(CLMA)，以此取代气管导管或面罩用来维持患者自主或正压通气。第一代喉罩最大的缺点就是不能防止胃内物误吸。CLMA不适用于非严格禁食者或有误吸危险的患者，此类情况下，第三代喉罩——ProSeal喉罩(PLMA)就发挥了作用。PLMA由Archie Brain在2000年发明，其发明初衷在于针对那些既要维持通气又要允许胃液排出的患者 ......
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