Effect Of Pressure Control Of Domestic Laryngeal Mask Airway On Postoperative Sore Throat

Objective: To investigate the effect of domestic double-tube laryngeal mask pressure on postoperative sore throat,so as to provide clinical reference for pressure control of double-tube laryngeal mask.Methods: One hundred and twenty patients undergoing elective general anesthesia?including breast surgery,urology,and supine surgery for lower extremity operation?were selected and operated for 180 minutes.Gastrointestinal surgery without gastric tube,Non-laparoscopic surgery),American Society of Anesthesiologists?ASA??-?level,aged 18-65 years.The size of the laryngeal mask was calculated according to the standard weight?calculated according to Broca formula,calculated according to Broca's modified formula?.According to the size of the body weight,the interval of the laryngeal mask was selected,and the size of the laryngeal mask was calculated by the random number table method.And select the appropriate laryngeal mask.Patients after entering the operating room,open venous access,and monitoring of patients with pulse oximeter oxygen saturation,heart rate,blood pressure,mean arterial pressure etc.,before the insertion of the laryngeal mask in the back of the laryngeal mask coated with lubricant to fully lubricated.The induction of anesthesia was the same in both groups.The patients were anesthetized with etomidate 0.3mg / kg,cisapride atracurium 0.2mg / kg,sufentanil 0.5?g / kg and midazolam 0.05 mg / kg.Intravenous pressure was measured by VBM Mdizintechnik GmbH?Germany?,and the internal pressure was measured by working five?5?.After three minutes of injection,the mandibular laxity was removed and the consciousness disappeared.The anesthesiologists operated an overturn method.Group A was inflated to a pressure of 30 cm H₂O via VBM meter,and group B was inflated to 60 cm H₂O.Inflammation of the two groups of patients with laryngeal mask air and ventilation,observation of patients with thoracic fluctuation,anesthesia machine to observe the pressure waveform,while about 1cm of the gel column into the esophageal drainage tube,press the sternal fossa observed gel With or without fluctuations.After the insertion of the laryngeal mask,the sealing pressure of the laryngeal mask was measured.If the laryngeal mask is inserted after a serious leak,ventilation is not ideal,the balloon can be deflated,remove the laryngeal mask and then re-insert.After the completion of the examination,the use of tape for fixed and parallel mechanical ventilation,set the respiratory rate of 12 times / min,tidal volume of 8 ml / kg,oxygen flow rate of 2L / min,breathing ratio I: E = 1: 2.During the operation,remifentanil 0.05-0.2?g / kg · min,propofol 4-8mg / kg · h,interval of 30-40 min were given 2-4mg cisatracurium.During the operation to pay attention to check the stomach,esophageal drainage tube,mouth with or without leakage.Two groups of patients anesthesia,ventilator ventilation mode no difference.Surgery to be awake after the patient pulled out the laryngeal mask,Steward awake score 5 points enough to return to the ward.?T0?,immediately after induction of anesthesia?T1?,immediately after the insertion of laryngeal mask?T2?,after the insertion of the laryngeal mask,after the laryngeal mask was inserted into the laryngeal mask,The MAP and HR of the two groups were recorded at 3min?T3?,at the end of operation?T4?,immediately after the removal of the laryngeal mask?T5?and 3min after the removal of the laryngeal mask?T6?.The placement of the laryngeal mask was observed in two groups of patients,including the time of insertion?insertion of the laryngeal mask into the laryngeal mask and the insertion of the laryngeal mask?and the number of laryngeal masking.The time of operation,the time of removal of laryngeal mask,the time of laryngeal mask removal after operation,the duration of awakening,and the time of eye opening were recorded.The patients were followed up for 2 hours,24 hours and 48 hours.The patients were followed up and recorded the sore throat.At the same time,the incidence of oropharyngeal sensory disturbance,hoarseness,swallowing discomfort and other complications were compared.Result:?1?Comparison of the two groups of patients in general.There were no significant differences in the height,age,sex,ASA grade,body weight,remifentanil dose,sufentanil dosage and operation time between the two groups.?2?The MAP and HR of the two groups were compared.There was no significant difference in the MAP and HR between group A and group B at T0,T1,T2,T3,T4,T5,T6 at all time points?P> 0.05?.?3?Laryngeal mask placement in two groups of patients compared.?5.18 ± 1.12?min,?5.19 ± 1.11?min,5.00% vs 6.67%,6.67% vs 6.67%,respectively.The time of laryngeal mask insertion in group A and B was 5.00%),no significant difference,all P> 0.05.?4?Laryngeal mask removal time and awake time were compared between the two groups.There was no statistical difference between the time of laryngeal mask extraction in group A and B [?8.81 ± 2.25?min vs?8.86 ± 2.31?min] and the awake time [?5.88 ± 1.36?min vs?5.85 ± 1.42?min],Both P> 0.05.?5?Two groups of patients with postoperative sore throat compared.The VAS score of group A was?2.25 ± 0.43?points and that of group B was?6.36 ± 1.05?points.The VAS score of group A was significantly lower than that of group B?P <0.05?The incidence of sore throat in group A was 41.67%.The incidence of sore throat in group A was significantly lower than that in group B,P <0.05.?6?The incidence of postoperative pharyngeal complication in 2 groups.The incidence of oropharyngeal sensory disturbances?5.00% vs 23.33%?,hoarseness?3.33% vs 18.33%?and swallowing discomfort?20.00% vs 45.00%?in group A were significantly lower than those in group B,P <0.05.Conclusion: Compared with 60 cm H₂O cuff inflation pressure,30 cm H₂O cuff inflation pressure can effectively reduce oropharyngeal sensory disturbance,hoarseness,swallowing discomfort,sore throat and so on under home-made double tube laryngeal mask anesthesia.Complications,and can effectively relieve the patient's postoperative symptoms of sore throat,so in clinical applications,should make the cuff inflation pressure to achieve the minimum effective sealing pressure is appropriate.