Application Of General Anesthesia Retaining Spontaneous Respiration With Laryngeal Mask In The Gynecological Hysteroscopic Surgery

Objective:To explore the feasibility,safety,and the influence of complications during recovery from anesthesia and after surgery in general anesthesia method of laryngeal mask retaining spontaneous breathing in gynecological hysteroscopic surgery.Methods:From October 2021 to January 2022,60 patients（18-65 years old,ASA gradeⅠ～Ⅲ）who underwent gynecological hysteroscopy in our hospital were selected and randomly divided into three groups: traditional endotracheal intubation machinery ventilation group（group A）,laryngeal mask mechanical ventilation group（group B）,laryngeal mask retaining spontaneous breathing group（group C）.Inoperative anesthesia was maintained by all-vein approach with BIS calibration 50 –60.Changes in hemodynamic and respiratory mechanics indicators,medication dosage,recovery time of anesthesia and complications after general anesthesia in the three groups of A,B and C were recorded.Results:1.A total of 60 patients completed the test,20 patients in each of the three groups A,B,and C.The basic data（age,BMI value,ASA grade）of the three groups of patients and related indicators（MAP,HR,SPO2）before induction of anesthesia were not significantly different between the groups（P>0.05）.2.In the three groups of patients,1 min after intubation（T1）,when entering the lens（T2）,15 minutes after entering the lens（T3）,immediately after extubation（T4）,5 minutes after extubation（T5）,and 10 minutes after extubation（T6）There was no significant difference in HR,MAP,and SPO2 between the groups（P>0.05）;the difference between Pet CO2 and ppeak groups at different time points（T1～T3）in the three groups of patients was statistically significant（P<0.05）),the Pet CO2 value of C group is higher than that of A and B groups,and the ppeak value is lower than that of A and B groups.3.Comparison of the time from drug withdrawal to call（H1）,the time from drug withdrawal to extubation（H2）,and the time to stay in the recovery room（H3）of the three groups of patients.Group C compares with A and B groups,and compares the differences in pairs.All were statistically significant（P<0.05）.4.Intraoperative propofol dosage,the difference between group C and group A and group B was statistically significant（P<0.05）,and the difference between group A and group B was not statistically significant.Intraoperative remifentanil dosage,vasopressor and atropine dosage were not statistically different between the three groups（P>0.05）.5.In the choking score,the difference between group A and group C was statistically significant（P<0.05）.In the agitation score,the difference was not statistically significant（P>0.05）.In terms of postoperative complications,the three groups of patients had postoperative nausea and vomiting,postoperative reflux and aspiration,limb movement during airway device placement,laryngospasm,and blood stains in the mouth or device after the airway device was removed.There was no difference.Statistically significant（P>0.05）.However,in postoperative sore throat,the difference between group A and group B and C was statistically significant（P<0.05）.Conclusion:For gynecological hysteroscopic surgery,the general anesthesia with the laryngeal mask retaining spontaneous breathing can provide satisfactory surgical conditions,stable intraoperative hemodynamics,and has a faster recovery from anesthesia than the traditional endotracheal intubation mechanical ventilation group,and during the recovery period The advantage of lower incidence of coughing and lower incidence of postoperative sore throat.However,whether the impact of long-term postoperative pulmonary complications and long-term surgery are equally safe remains to be further studied.