Evaluation of the laryngeal mask airway for spontaneous breathing in short pediatric operation under Sevoflurane inhalation anesthesia / 中国小儿急救医学

ABSTRACT

Objective To evaluate the effects of the laryngeal mask airway for spontaneous breath-ing in short pediatric operation under Sevoflurane inhalation anesthesia.Methods Eighty children undergo-ing hernia surgery, of whom ASA Ⅰ or Ⅱ, in accordance with the random number table, were randomly divided into two groups( each 40 cases)the laryngeal mask airway for spontaneous breathing with Sevoflu-rane inhalation anesthesia in group A,and tracheal intubation for controlled ventilation with Sevoflurane inha-lationa nesthesia in group B.Children in the two groups were fasting for 6 hours and without drinking for 4 hours before anesthse ia.Anestheis a was induced with Sevoflurane inhalation fro all patients.The laryngela mask airway was insertde soon afet r induction of anesthesia with Sevoflurane inhalation,and anse thesia main-tained with Sevoflurane in halta ion in gor up A.P atients in gruo p B wereg iven cisatracurium 0.15 mg/kg intravenous injectio n before tracheal intubation, and anesthesia maintained with Sevoflurane inhalation, 40 minutes before the end of the surgeryt o sot p using muscle relaxant.Ten minutes before the end of the operation to stop Sevoflurane inhalation,in two groups.The end-tidal carbon dioxide partial pressure(PETCO2 ), mean blood pressure,heart rate,respiratory rate,pulse oxygen saturation and end-tidal sevoflurane partial pres-sure(PETSev) were recorded one minute before the induction of anesthesia,15 min,30 min,45 min,and 60 min after the induction of anesthesia.Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were recorded in two groups.Results The mean blood pressure, heart rate decreased in two groups after the induction of anesthesia(P<0.05).The value of PaCO2 increased and that of base excess decreased in 30 min after the induction of anesthesia in group A(P<0.05).The value of PETCO2 increased, and that of pH decreased in 45 min after the induction of anesthesia in group A (P<0.05).The movements of the limbs and head induced by operative stimulation in group A were more than those in group B(P<0.05),but the incidences of cough and laryngospasm induced by removing the laryngeal mask airw ay or tracheal catheter in group B were higher than those in group A(P<0.05).Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were shorter in group A than those in group B ( P<0.05 ) .Conclusion It is safe that the laryngeal mask airway for spontaneous breathing with Sevoflurane inhalation anesthesia in short pediatric operation.The time of anesthe-sia is beyond half an hour during operation and the artificial respiration sholu d be implemented.