纤维支气管镜在ProSeal喉罩气道定位中的作用

Guo-hua Sun, Zhao-ping Zhang, Zheng Zhang, Gao Hong
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摘要

目的探讨纤维支气管镜(FOB)在ProSeal喉罩气道(PLMA)定位中的作用。方法ASAⅠ或Ⅱ行PLMA全麻患者60例,随机分为两组,每组30例:A组置入PLMA组(A组)和FOB定位组(B组)。常规静脉麻醉诱导后,将PLMA充气至囊内压力为50 cm H2O (1 cm H2O =0.098 kPa),麻醉器维持气道正压,评估气道密封压力、间歇正压通气气道峰值电压和潮气量。结果两组患者肺通气良好(SpO2 >0.97,PETCO2正常),手术顺利。2次调整位置5例,3次调整1例。B组患者均在FOB下插入PLMA,气道密封压力较高,但气道峰值电压低于A组(P<0.05)。结论离心式通气可提高声门瓣的准确配置,增强声门瓣与周围组织的分离功能,改善肺通气,提高声门瓣的安全性。关键词:支气管镜;麻醉,一般;咽前面罩气道;本地化
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The role of fiberoptic bronchoscopy in the positioning of ProSeal laryngeal mask airway
Objective To investigate the role of fiberoptic bronchoscopy (FOB) in the positioning of ProSeal laryngeal mask airway (PLMA). Methods Sixty ASA Ⅰ or Ⅱ patients undergoing general anesthesia using PLMA were randomly divided into two groups with 30 cases each: inserted PLMA group (group A)and FOB positioning group (group B). After the routine intravenous anesthesia induction,the PLMA inflated to an intracapsular pressure of 50 cm H2O (1 cm H2O =0.098 kPa) with the positive airway pressure by the anesthesia apparatus, the airway seal pressure, airway peak voltage of intermittent positive pressure ventilation and tidal volume were evaluated. Results Patients from two groups achieved adequate lung ventilation (SpO2 >0.97,PETCO2 was normal), the operations were all smooth. There were 5 cases adjusted the position two times,and 1 case adjusted 3 times. Patients in group B were all PLMA insertion under FOB and airway seal pressure was higher,but airway peak voltage was lower than in group A (P<0.05). Conclusion FOB elevates accurate allocation of PLMA,enhances the isolated function from the surrounding tissue of glottis, improves the lung ventilation, and increases the safety of PLMA. Key words: Bronchoscopes; Anesthesia,general; ProSeallaryngeal mask airway; Localization
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