Analysis Of The Effect Of Pretreated OPLAC On The Ventilation Effect Of Gynecologic Laparoscopic Surgery

Laparoscopic surgery has the characteristics of small trauma,clear vision,and less adhesion of postoperative organs.It has been widely used in gynecological surgery.The focus of anesthesia is ventilation management,which can timely discharge carbon dioxide to avoid retention.As a new type of ventilation tool,laryngeal mask has been widely used in various general anesthesia because of its small trauma,mild hemodynamic impact on patients,simple operation and broder tolerance.The OPLAC is made according to the characteristics of the throat structure of Chinese.It has the characteristics of no cuff or inflation,and the functional characteristics of high airway seal and intermittent compression on the mucosa of throat.It has ideal effect on ventilation of laparoscopic surgery.In order to smoothly inserting the OPLAC,improving the one-time insertion success rate,reducing the mechanical damage caused by repeatedly adjusting the position of the laryngeal mask on the throat of patient and improving the ventilation efficiency,the clinical practice often adopts different methods to pretreat the laryngeal mask,such as applying Dyclonine glue to the back of the laryngeal mask.In clinical application,it was found that at the beginning of the mechanical ventilation of the OPLAC,the peak pressure of the airway was very high,and it quickly fell to a stable level after a period of time.Maybe it is related to the softening of the silicone cap and the cork ring.The pretreatment method is to apply Dyclonine glue to the back of the laryngeal mask,and another pretreatment method is pre-wetting the laryngeal mask by moistening the silicone cap and cork ring in advance,and comparing the effects of the two pretreatment methods on gynecological laparoscopic ventilation and the impact of postoperative complication of sore throat,providing a scientific basis for clinical application.Objective:To compare the application of applying Daconine glue on the back of the mask and the pre-wetting treatment of the cork ring inside the OPLAC by physiological saline.These two pretreatment methods were used to manage the airway and reduce the post operative complication of pharynx pain in gynecological laparoscopic surgery.To provide the scientific basis for more safe and effective application of OPLAC.Methods:Ninty cases of Gynecological laparoscopic elective surgeries were randomly divided into three groups:Group A is Daconine group on the back of the OPLAC,Group B is Pre-wet treated cork ring in the OPLAC by physiological saline,Group C is blank control group without any pretreatment.After induction of anesthesia,different methods of pre-treatment of laryngeal mask were placed,and mechanical controlled ventilation was performed.The insertion time of larynx mask,one-time success rate,peak of airway pressure(Ppeak),Oropharyngeal Leak Pressure(OLP),at the beginning of mechanical ventilation were observed and recorded,and the difference between tidal volume(VT)and expiratory tidal volume(VTE)was set.After pneumoperitoneum,Ppeak、OPL and the difference between VT and VTE were observed and recorded again.Incidence of pharyngeal pain after removal of larynx mask after operation.Result:Compared with the other two groups,Group A was less time-consuming than the other two groups,and the success rate was high(P<0.05).The B group was compared with the C group,and the B group had a high success rate(P< 0.05).At the beginning of mechanical control ventilation,comparison between the three groups.The Ppeak and VT-VTE values of group B were lower than those of group A and group C(P<0.05),and the OLP valuewas greater than the other two groups(P<0.05).There was no significant difference in Ppeak,VT-VTE,OLP between group A and group C at the beginning of mechanical control ventilation(P>0.05).There were no significant differences in Ppeak,VT-VTE and OLP between the three groups after pneumoperitoneum(P>0.05).Ppeak after pneumoperitoneum was significantly higher than the Ppeak before the pneumoperitoneum in three groups(P<0.05).VT-VTE after pneumoperitoneum was smaller than the pre-pneumoperitoneum value of the three groups(P<0.05).The OPL after pneumoperitoneum of group A and group C was higher than that before pneumoperitoneum(P<0.05).There was no significant difference in OPL of group B before and after pneumoperitoneum(P>0.05).The incidence of postoperative sore throat was lower in group A and group B than in group C(P<0.05).There was no significant difference in the incidence of sore throat between group A and group B(P>0.05).Conclusion:The application of dyclonine glue on the laryngeal mask can shorten the placement time and reduce postoperative discomfort such as pharyngeal pain.The pretreatment of the laryngeal mask with normal saline can improve the quality of ventilation at the beginning of mechanical ventilation and also improve the patient’s tolerance to the laryngeal mask,which is more suitable for the requirements of high-quality ventilation effect in gynecological laparoscopic surgery.