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目的:比较喉罩麻醉小儿疝手术不吸引侧卧位复苏与平卧位吸引复苏的效果。方法:选择0.5~3岁择期疝手术男性小儿48例,ASAⅠ~Ⅱ级,术前无呼吸系统感染、哮喘及胃肠胀气,均采用喉罩全麻。根据术毕复苏方式不同,分为侧卧位口腔不吸引复苏组(A组,n=24)和平卧位口腔吸引复苏组(B组,n=24)。所有病例均采用快诱导置入喉罩,术中监测BP、HR、ECG、Sp O2、PETCO2,听诊呼吸音及痰鸣音,观察气道压变化及喉罩漏气情况。术毕根据组别采用侧卧位不吸引复苏或平卧位吸引复苏。结果:48例小儿诱导平稳,喉罩控制呼吸满意,术中生命体征平稳,两组均未见返流误吸,B组患儿复苏期躁动、口腔黏膜出血及复苏时间明显大于A组(P<0.05)。结论:喉罩麻醉下侧卧位口腔不吸引复苏,可减少或避免误吸及口腔黏膜出血并发症,缩短复苏时间,复苏质量优于平卧位口腔吸引拔管。
Objective: To compare the effect of laryngeal mask anesthesia in pediatric hernia surgery not to attract lateral resuscitation and supine decubitus resuscitation. Methods: A total of 48 male children undergoing elective hernia operation from 0.5 to 3 years old, ASA Ⅰ ~ Ⅱ, without respiratory infection, asthma and flatulence before operation were selected. According to the different modes of recovery, the patients were divided into non-traction resuscitation group (A group, n = 24) and supine oral resuscitation group (B group, n = 24). All patients were treated with rapid induction laryngeal mask. BP, HR, ECG, Sp O2, PETCO2, auscultation of breath sounds and phlegm were monitored to observe the change of airway pressure and leakage of laryngeal mask. Surgery based on the group using the lateral position does not attract recovery or supine position to attract recovery. Results: In 48 cases, the laryngeal mask was controlled and the respiration was satisfactory. The vital signs during operation were stable. No reflux aspiration was found in both groups. The recovery of agitation, oral mucosal hemorrhage and recovery time in group B were significantly longer than those in group A (P <0.05). Conclusion: Laryngeal mask anesthesia does not attract the resuscitation in the lateral position, which can reduce or avoid the complications of aspiration and oral mucosal hemorrhage and shorten the recovery time. The quality of resuscitation is better than that of the supine oral cavity.