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目的:研究双管喉罩(PLMA)在小儿眼科麻醉中应用的可行性和安全性。方法:择期小儿眼科手术患者180例,随机均分为(P组)双管喉罩组、(L组)普通喉罩组、(T组)气管插管组。记录麻醉诱导前(T0),置入喉罩(导管)后(T1),手术开始1分钟后(T2),手术刺激最强(T3),拔出喉罩(导管)前(T4),出手术室前(T5),的心率(HR),平均动脉压(MAP),脑电双频指数(BIS)值。记录手术时间、拔管时间、麻醉药用量(丙泊酚用量)、苏醒时间及拔管后不良反应(呛咳、低氧血症、喉痉挛、声音嘶哑、咽喉痛)。结果:P组、L组喉罩一次性置入成功率高于T组气管导管一次性插入成功率。P组和L组丙泊酚用量明显低于T组(P<0.05)。与T组比较P组、L组在T1、T2、T3、T4时HR较慢,MAP较低,BIS值较高(P<0.05),T组血流动力学波动明显大于P组、L组。P组和L组苏醒时间明显短于T组(P<0.05)。结论:在小儿眼科手术麻醉中,PLMA放置成功率高,血流动力学平稳,术中通气情况良好,发生反流、误吸、分泌物增多等并发症少,苏醒迅速,是一种安全有效的麻醉方法。
Objective: To study the feasibility and safety of double-laryngeal mask (PLMA) in pediatric ophthalmic anesthesia. Methods: A total of 180 patients undergoing elective pediatric ophthalmic surgery were randomly divided into two groups: group P (P group) laryngeal mask group, group L (L group) general laryngeal mask group and group T (T group) tracheal intubation group. Record anesthesia induction (T0), placed laryngeal mask (catheter) (T1), 1 minute after the start of surgery (T2), the strongest surgical stimulation (T3), pull out the mask (catheter) before (T5), heart rate (HR), mean arterial pressure (MAP) and bispectral index (BIS) before surgery. The operation time, extubation time, dosage of propofol (propofol), recovery time and adverse reactions after extubation (choking, hypoxemia, laryngospasm, hoarseness, sore throat) were recorded. Results: The success rate of one-time placement of laryngeal mask in group P and group L was higher than that in group T. The dosage of propofol in P group and L group was significantly lower than that in T group (P <0.05). Compared with group T, HR of HR group was slower, MAP was lower, BIS value was higher in group P and group L (P <0.05), and the hemodynamic fluctuation in group T was more than that in group P and L . The recovery time of P group and L group was significantly shorter than that of T group (P <0.05). Conclusion: In pediatric ophthalmic anesthesia, PLMA has a high success rate, stable hemodynamics, good intraoperative ventilation, reflux, aspiration, secretions and other complications with less complications and rapid recovery. It is a safe and effective method Anesthesia method.