| This paper aims to study hemodynamic changes and clinical application about the security of two kinds of airway management methods which are trachea pipe and laryngeal mask under general anesthesia in elective pediatric abdominal surgery.Objective: The aim of this study is to observe the hemodynamic changes of two kinds of airway management methds, trachea pipe and laryngeal mask .then to offer more reliable evidence for choosing laryngeal mask under general anesthesia in the pediatric colorectal surgery.Methods: 40 cases of pediatric patients under selective abdominal surgery were choosen to study. ASA: I - II, were randomized into A and B group.group A is laryngeal mask group (n=20) and group B is endotracheal tube group (n=20). 40 Patients (3-8 years) scheduled to undergo selective colorectal surgery, weight 10-30kg. Before operation, patients have no throat sore, no tracheal obstruction, no apparent abnormality in psychology and nerve, no antiadoncus, no loosening of teeth, no esophageal reflux, no laryngeal softening history, and no respiratory infections in Nearly two weeks. The surgical time is about 1 hour and the study has been acquired the consent of patients'relatives. Surgery include resection of hemangioma of abdominal wall, appendectomy, orchidopexy, and fold inguen herniorrhaphy, and so on. All patients forbidden drink and diet for 4-6h. And patients will be injected intramuscularly 0.02 mg/kg of atropine and will take 0.5-0.75mg/kg midazolam by mouth in 30min before operation. After patinents entered into operation room, oxygen uptake, open vein injection and link monitor. The method of anesthesia and drugs are identical in two groups. anesthesia induction: inspired oxygen by mask 5L/min and sevoflurane, 8% for 3 minutes, Midazolam 0.05 mg/kg, fentanyl 2~4μg/kg. anesthesia maintain: 1.5% sevoflurane,then according to the situation, given anesthesia analgesia and muscle relaxation drugs interruptedly. Anesthesia depth will reach to: no reflexes of eyelids and loose of submaxilla. According to the age and weight of patients, proper laryngeal mask and tracheal intubation were given. The tube establishiment of all patients will be operated by the same doctor.Monitor: there are seven time point: before induction (T0), after induction (T1), after laryngeal mask or tracheal intubation immediately (T2), after intubation 3 min (T3), 3min before extubation (T4) ,extubation (T5), after extubation (T6), observe MAP, DBP SBP, HR, SPO2 and PETCO2 at every time point, and observe the rate of the first tracheal intubation and whether exsit bucking, breathholding , body movement, cough, laryngospasm, contraflow, aspiration in the time of extubation.Results: the alteration of hemodynamics: there is no obviously difference of MAP and HR between T0 and T1 time point (P>0.05). Between T2 and T3 time point, there is significant difference of MAP and HR (P<0.05). And there is significant difference of MAP and HR between every group at T5 time point (P<0.05).Side effect: there are no movement of body in the two group when inserted catheter tube; when extubate catheter tube, there is one patient have body movement, one patient have breathholding in group A; however, in group B, there are two patient have bucking, one patient have laryngospasm ,four patient have body movement and one patient with blood in tube. The achievement ratio of inserted tube is 98% in the two groups.This research showed that, compared with endotracheal tube, application of laryngeal mask airway under general anesthesia in pediatric selective colorectal surgery can alleviate hemodynamics, and facilitate postoperative recovery via attenuating stimulation of respiratory tract. laryngeal mask is better than endotracheal tube in the pediatric general anesthesia.
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