OPLAC喉罩在腹腔镜子宫切除手术中的临床应用山东省临沂市沂水中心医院麻醉科276400【摘要】目的评估OPLAC喉罩在腹腔镜子宫切除手术麻醉中的应用效果，并探讨其安全性和有效性。方法随机将全身麻醉下腹腔镜行子宫切除术的子宫肌瘤患者80例，分为两组：OPLAC喉罩组（L组）和气管插管组（T组）。分别记录人工气道建立成功时、成功后30min及手术结束时的平均气道压（Pmean）、气道峰压（Ppeak）、呼气末二氧化碳分压（PetCO2）和患者入室时（T1）、人工气道建立成功时（T2）、建立后lOmin（T3）、拔管（喉單）前即刻（T4）、拔管（喉罩）后即刻（T5）的平均动脉压（MAP）、心率（HR）；并观察术中有无反流误吸情况及术后咽喉部并发症，如声嘶或咽痛等。结果喉罩组和气管插管组在人工气道建立成功时、成功后30min及手术结束时的Pmean、Ppeak、PetC02比较，差异均无统计学意义。两组在T1时的MAP和HR比较，差异无统计学意义；喉罩组在T2〜T5时的MAP、HR明显低于同时点的气管插管组，差异均有统计学意义。两组各时间点SpO2均为100%。喉罩组术中未发现1例反流误吸患者。两组术后各发生3例轻微咽痛，均未见声音嘶哑。结论全麻OPLAC喉罩通气用于腹腔镜子宫切除术患者优于气管插管，易于维持血流动力学稳定，应激反应轻微，全麻后恢复平稳。【关键词】OPLAC喉罩；全身麻醉；腹腔镜子宫切除ClinicalapplicationofOPLAClaryngealmaskinhysterectomyunderlaparoscopyYangMengchenDepartmentofAnesthesiology，YishuiCenterHospital,LinyiofShanDong276400[AbstractJObjectiveToassessthesafetyandefficacyofgeneralanesthesiawithOPLACIaryngealmaskinhysterectomyunderlaparoscopy.MethodEightypatients（ASAI〜Il）scheduledtoundergohysterectomyunderlaparoscopywithgeneralanesthesiawererandomizedintotwogroups：OPLACIaryngealmaskairwaygroup(groupL)andendotrachealintubationgroup(groupT).Pmean,PpeakandPETCO2weremeasuredatintubationorlaryngealmaskinsertion，30minafterintubationorlaryngealmaskinsertion，afteroperationintwogroups，respectively.MAPandHRwererecordedatbeforeanesthesia(Tl)，successfulairwayplacement(T2)，10minaftersuccessfulairwayplacement(T3),beforeextubationorlaryngealmaskremoval(T4),afterextubationorlaryngealmaskremoval(T5)intwogroups,respectively.Reflex,aspirationandsideeffectswithlaryngealmaskinsertionincludingthroatsoreness，hoarseness，etcwerecarefullymonitoredduringperioperation.ResultsPmean,PpeakandPETCO2hadnosignificantdifferenceintwogroupsatthetimeofintubationorlaryngealmaskinsertionwassuccessful，after30min,andafteroperation.MAPandHRhadnosignificantdifferenceintwogroupsatthetimeofTl.IngroupT,MAPandHRweresignificantlyhigherthangroupLatthetimeofT2~T5.Nopatientshowedanysignsofreflex,aspirationduringoperationingroupLThreepatientswerereportedslightthroatsoreness，butnopatientsshowedhoarsenessafteroperationintwogroups,respectively.ConclusionsOPLAClaryngealmaskcontributedmorestablehemodynamics，lesscardiovascularstressandshorterrecovertimecomparedtoendotrachealintubationtechniqueinpatientsundergoinghysterectomywithlaparoscopy..[Keywords]OPLACIaryngealmask；generalanesthes,laparoscopy，hysterectomy.【中图分类号】R713.4+2【文献标识码】A【文章编号】2096-0867(2016)-07-008-02喉罩(LaryngealMaskAirway,LMA)的逐步改进和使用经验的不断积累，使其临床应用越来越广泛。最初用于一般患者短小手术麻醉中保持自主呼吸时的气道管理，但现在已发展到困难气道的处理。困难插管和气道反应仍然是气道管理的难题，气管插管仍然是全麻下气道管理的主要方法，OPLAC喉罩(oplaclaryngealmaskairway,台湾旭邦工业有限公司生产)与^管内插管相比较，喉罩刺激小，呼吸道机械性梗阻少，插入和拔出心血管系统反应较小，术后较少发生咽喉痛。本次研宄旨在观察OPLAC喉罩在...