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喉罩通气道(Laryngeal Mask Airway,LMA)由Brain在1983年首先运用和介绍。本文报道日本国立儿童医院应用喉罩通气道120例的经验,病儿年龄2月到12岁。LMA的适应症和面罩相同,但估计气管插管和面罩操作困难时,特别有用。麻醉前用药为阿托品0.02mg·kg~(-1)im和安定0.7mg·kg~(-1)口服,用氟烷—N_2O-O_2作麻醉诱导和维持,不用肌松药,当麻醉有一定深度后再行操作。首先把病儿的头(不是肩)放在枕上,置抬颈弯曲头后伸的小儿插管体位。经投次纯氧呼吸,用左手手指使口张开,用左手腕支托前额,保持头过伸位。不用喉镜,将涂好润滑油的LMA沿硬腭轻柔推进,在稍感阻力后,再连续平稳地将LMA向下插,直至感到另一阻力。向气囊充气,接上麻醉装置,通过挤压呼吸囊和观察胸廓运动证实LMA位置正确,记录LMA插入深度。从门齿处计算插入深度,与年龄关系有一粗略公式:深度=10cm+0.3×年龄。在麻醉开始时,测量挤压呼吸囊能听到漏气的临界压,然后在整个麻醉中,每二、三次自主呼吸做一次低于临界压的扶助呼吸,临界压从8cmH_2O到30cmH_2O,平均为18cmH_2O。头部保持过伸位以防LMA扭曲。手术结束后由氟烷和氧气维持一定麻醉深度,以避免拨LMA引起的喉痉挛。在吸痰
Laryngeal Mask Airway (LMA) was first introduced and introduced by Brain in 1983. This article reports the experience of 120 cases of laryngeal mask ventilation in Japan National Children’s Hospital. The sick child’s age is from February to 12 years. The indications for LMA are the same as masks, but they are particularly useful when it is difficult to assess the effectiveness of intubation and masks. Anesthesia before administration of atropine 0.02mg · kg ~ (-1) im and diazepam 0.7mg · kg ~ (-1) orally, with halothane-N_2O-O_2 for induction and maintenance of anesthesia, without muscle relaxants, when a certain anesthesia Depth and then operate. First of all sick child’s head (not shoulder) on the pillow, lift the neck curved head extension of pediatric intubation position. The pure oxygen breathing after the vote, with the left hand fingers open mouth, with his left wrist support forehead, head extension over bit. Without a laryngoscope, lubricate the lubricated LMA gently along the hard palate, and after a little resistance, continue to steadily lower the LMA until it feels another resistance. Inflate the balloon, connect to the anesthesia device, confirm the LMA position is correct by squeezing the respiratory capsule and observing the thoracic motion, and record the LMA insertion depth. Calculating insertion depth from incisors has a rough approximation of age: Depth = 10 cm + 0.3 × age. At the beginning of anesthesia, the crushed breathing balloon can be measured to hear the critical pressure of the leak, and then every second and third spontaneous breath during the anesthesia to do a sub-critical pressure of assistive breathing, the critical pressure from 8cmH2O to 30cmH2O, with an average of 18cmH2O. Keep the head extended to prevent LMA distortion. After surgery to maintain a certain depth of anesthesia by halothane and oxygen to avoid dial laryngeal spasm caused by LMA. Suction sputum