Effect of Proseal laryngeal mask airway on stress reaction in patients with interventional procedures in department of neurosurgery
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摘要: 目的 观察Proseal型喉罩置入对神经外科介入手术患者血流动力学及应激性反应的影响。 方法 选择2015年1—8月收治的需行神经外科介入手术的患者80例作为研究对象。患者均符合手术指征,ASA分级Ⅱ~Ⅲ级,按照配对分组法分为2组,每组40例,2组均给予长托宁0.5 mg、咪达唑仑0.05 mg/kg、依托咪酯0.3 mg/kg、罗库溴铵0.6 mg/kg,芬太尼3 μg/kg,面罩给氧,肌松满意后,对照组采取气管内插管全身麻醉,观察组给予Proseal型喉罩置入,记录2组患者不同时刻血流动力学相关指标及皮质醇水平。 结果 观察组插管时、插管5 min及拔管时MAP、HR分别为(85.9±10.2) mm Hg、(83.6±9.4) mm Hg、(87.6±8.9) mm Hg、(69.8±6.7)次/min、(68.7±6.9)次/min、(65.3±6.9)次/min,均低于对照组的(95.4±9.6) mm Hg、(90.1±8.3) mm Hg、(96.4±9.3) mm Hg、(75.8±6.8)次/min、(76.1±7.2)次/min、(71.4±6.5)次/min,血流动力学更为平稳,P均<0.05。观察组插管时、插管5 min、拔管时、拔管后5 min皮质醇水平均分别为(34.6±1.1) ng/ml、(34.1±1.2) ng/ml、(37.9±1.5) ng/ml、(37.4±1.9) ng/ml,均低于对照组的(35.9±1.2) ng/ml、(35.8±1.3) ng/ml、(40.3±1.6) ng/ml、(40.9±2.1) ng/ml,差异具有统计学意义,P<0.05。 结论 Proseal型喉罩置入对神经外科介入手术患者应激性反应水平较低,血流动力学更为平稳,具有重要的临床价值。
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关键词:
- Proseal型喉罩 /
- 介入手术 /
- 应激性反应
Abstract: Objective To observe the effect of Proseal laryngeal mask(LAM) airway on the hemodynamics and stress response of patients with interventional procedures in department of neurosurgery. Methods Total 80 patients undergoing interventional surgery in our hospital from January,2015 to August,2015 were selected as the research objects.All patients met the indications for surgery treatment,ASA grade Ⅱ-Ⅲ level.According to the paired grouping method they were divided into two groups with 40 cases in each group.Two groups were given penehyclidine hydrochloride 0.5 mg/kg,midazolam 0.05 mg/kg,etomidate 0.3 mg/kg,rocuronium bromide 0.6 mg/kg,fentanyl 3 μg/kg,given oxygen mask,when muscle were relaxant,the control group were treated with endotracheal intubation while the observation group was given Proseal type laryngeal mask.The blood flow dynamics related indicators and level of cortisol at different time points were compared between the two groups. Results MAP during intubation,5 min after intubation and during extubation were (85.9±10.2)mm Hg,(83.6±9.4)mm Hg and (87.6±8.9)mm Hg in the observation group,which were lower than (95.4±9.6)mm Hg,(90.1±8.3)mm Hg and (96.4±9.3)mm Hg in the control group;HR during intubation,5 min after intubation and during extubation were (69.8±6.7)/min,(68.7±6.9)/min and (65.3±6.9)/min,which were less than (75.8±6.8)/min,(76.1±7.2)/min and(71.4±6.5)/min in the control group,the results revealed a more stable blood flow kinetics when compared with the control group.The levels of cortisol during intubation,5 min after intubation,during extubation and 5 min after the extubation in the observation group were (34.6±1.1)ng/ml,(34.1±1.2)ng/ml,(37.9±1.5)ng/ml and (37.4±1.9)ng/ml,which were lower than (35.9±1.2)ng/ml,(35.8±1.3)ng/ml,(40.3±1.6)ng/ml and (40.9±2.1)ng/ml in the control group,the difference was statistically significant,P<0.05. Conclusion Proseal type laryngeal mask insertion in patients with neurosurgical intervention were with lower level of stress response and more stable hemodynamics.It has important clinical value.-
Key words:
- Proseal laryngeal mask(LAM) /
- Interventional procedures /
- Stress response
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