目的:比较I-gel喉罩与Supreme喉罩在全身麻醉甲状腺手术中的气道管理效果。方法全身麻醉下择期行甲状腺手术患者100例,ASAⅠ-Ⅱ级,随机分为I-gel喉罩组(I组,n=50)与Supreme喉罩组(S组,n=50)。记录喉罩置入前、后1、3、5min的血流动力学变化及喉罩置入后(T0)、手术开始时(T1)、术中牵拉甲状腺( T2)、及肿瘤切除后( T3)各时点的脉搏、氧饱和度( SPO2)、气道峰压( Ppeak )及口咽漏气情况的变化。记录喉罩气道密封压及纤支镜检查评级。记录术毕拔除喉罩的不良反应。结果两组患者各时点血流动力学、SPO2无差异(P>0.05)。与I组相比,T2时点S组Ppeak明显增高(P<0.05);口咽部漏气患者增多(P<0.05)。 I组喉罩气道密封压[(28±3)cm H2O]明显高于S组[(24±4)cmH2O](P<0.05),纤支镜检查评级I组优于S组( P<0.05)。结论 I-gel喉罩通气效果好,术中气道密封性更高,可安全有效的应用于全身麻醉甲状腺手术的气道管理。%Objective To compare the effects of the I-gel Laryngeal mask with the Supreme Laryngeal mask on airway management of patients during thyroid surgery under general anesthesia .Methods 100 patients with ASAⅠ-Ⅱundergoing selective thyroid surgery under general anesthesia were identified and randomized to I -gel ( Group I, n=50) and Supreme (Group S,n=50) group.The hemodynamic changes were recorded at the time before insertion and 1、3、5min after insertion The MAP and HR .The SPO2 ,Ppeak and Oropharyngeal leakage were recorded after la-ryngeal mask insertion ( T0 )、at the beginning of operation ( T1 )、at the time of intraoperative traction of the thyroid ( T2 ) and after resection of the thyroid gland ( T3 ) .We also recorded the airway sealing pressure and rating of fiber endoscopy ,as well as adverse reactions after the removal of Laryngeal mask .Results There were no significant differ-ences in WAP,HR and SPO2 between the two groups.At the time of T2,the Ppeak were higher,and more patients with oropharyngeal leakage were in groupS than that in group I (P<0.05).The airway sealing pressure in group I (28 ± 3cmH2O) was higher than that in group S(24 ±4cmH2O)(P<0.05),and the rating of fiber endoscopy was better in group I than group S(P<0.05).Conclusion The I-gel laryngeal mask airway works well ,with higher airway sealing pressure ,which is safe and effective when used in airway management during the thyroid operation under general anes -thesia.
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