全麻手术患者LMAS喉罩和SLIPA喉罩气道管理的效果

目的 比较全麻手术患者LMAS喉罩和SLIPA喉罩气道管理的效果.方法 择期全麻手术患者80例,年龄18～70岁,体重45～80 kg,ASA分级Ⅰ或Ⅱ级,随机分为2组(n=40):LMAS喉罩组(L组)和SLIPA喉罩组(S组).麻醉诱导后置入喉罩,行机械通气.记录MAP和HR、喉罩置入情况、喉罩置入时间、气道密闭压、最高气道压、平均气道压、置入喉罩后返流和误吸的发生情况、拔除喉罩后粘血的发生情况及术毕和术后24 h内咽痛的发生情况.结果 两组MAP和HR差异无统计学意义(P＞0.05).两组喉罩全部置入成功,一次置入成功率差异无统计学意义(P＞0.05).与L组比较,S组喉罩置入时间延长,气道密闭压降低(P＜0.05),最高气道压和平均气道压差异无统计学意义(P＞0.05).两组均未发生返流和误吸.与L组比较,S组喉罩粘血和术毕咽痛的发生率升高(P＜0.05),术后24 h内咽痛的发生率差异无统计学意义(P＞0.05).结论 LMAS喉罩和SLIPA喉罩置入简单易行,气道密封效果好,可有效保证通气,不良反应少.LMAS喉罩用于全麻手术患者气道管理的效果更好.     

免充气喉罩在老年腹腔镜手术加速康复外科中的应用

目的:观察免充气型(SLIPA)喉罩在老年腹腔镜手术患者加速康复外科中的应用效果。方法:按随机数表法将120例老年腹腔镜手术患者分为SLIPA组(n=60)与食管引流型(PLMA)喉罩组(n=60)。观察手术情况与置入情况,记录置入前(T_1)、置入即刻(T_2)、置入后5 min(T_3)、拔除即刻(T_4)、拔除后10 min(T_5)时血流动力学指标(平均动脉压、心率)的监测结果,比较T_1～T_5时两组患者应激反应指标(皮质醇、肾上腺素、去甲肾上腺素)水平,观察不良反应发生情况。结果:两组围手术期各指标、气道密封压差异无统计学意义(P>0.05)。SLIPA组一次置入成功率高于PLMA组,置入时间短于PLMA组,置入相关不良反应发生率低于PLMA组(P<0.05)。T_2～T_5时,SLIPA组平均动脉压、心率及血浆皮质醇、肾上腺素、去甲肾上腺素水平均低于PLMA组(P<0.05)。结论:老年腹腔镜手术中SLIPA喉罩置入效果、患者血流动力学及应激状态稳定情况、安全性优于PLMA喉罩,符合加速康复外科理念。     

Supreme喉罩用于妇科腹腔镜手术患者气道管理的效果

目的 评价Supreme喉罩用于妇科腹腔镜手术患者气道管理的效果.方法 择期行妇科腹腔镜手术的患者80例,ASA分级Ⅰ或Ⅱ级,年龄40～64岁,体重50～70 kg,身高158～170 cm,Mallampatis分级Ⅰ或Ⅱ级,随机分为2组(n=40):Supreme喉罩组(S组)和ProSeal喉罩组(P组).麻醉诱导后置入喉罩,行机械通气,并经引流管置入胃管.记录手术时间、气腹时间、清醒时间、喉罩置入时间、喉罩及胃管置入情况;记录喉罩囊内压为60 cm H2O时的充气量和气道密封压,并采用纤维支气管镜进行通气罩咽部解剖结构显露分级;术中监测BP、HR、ECG、SpO2、PETCO2,记录术后咽喉部不良反应的发生情况.结果 两组手术时间、气腹时间、清醒时间比较差异无统计意义(P＞0.05).两组术中BP、HR、SpO2、PETCO2、气道峰压均在正常范围,组间比较差异无统计学意义(P＞0.05).与P组比较,S组喉罩一次置入成功率、胃管一次置入成功率升高,喉罩置入时间缩短,通气罩咽部解剖结构显露分级升高,术后喉罩带血的发生率降低(P＜0.05);两组喉罩置入成功率均为100%,喉罩置入成功率、气道密封压、喉罩充气量比较差异均无统计学意义(P＞0.05).结论 Supreme喉罩通气效果好,气道密封性可靠,易于置入,可安全有效地用于妇科腹腔镜手术患者的气道管理.     

喉导管与SLIPA喉罩用于肥胖患者腹腔镜手术气道管理效果的比较

目的 比较喉导管与SLIPA喉罩用于肥胖患者腹腔镜手术气道管理的效果.方法 择期腹腔镜胆囊切除术患者60例,年龄40～60岁,性别不限,体重指数＞30 kg/m2,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机分为2组(n=30);喉导管组(Ⅰ组)和SLIPA喉罩组(Ⅱ组).两组均靶控输注异丙酚(血浆靶浓度3～5 μg/ml)和瑞芬太尼(血浆靶浓度4～6 ng/ml),静脉注射罗库溴铵0.6mg/kg,BIS值50 ～ 60时置入喉导管或SLIPA喉罩,行机械通气.观察指标:置入前后即刻、拔除前后即刻的HR、MAP;置入时间及次数；纤维支气管镜检查分级(评价置入位置)；气道密封压;术中SpO2、气道峰压(Ppeak)和PETCO2；气道管理失败、术中误吸及咽部不良反应的发生情况.结果 与Ⅱ组比较,Ⅰ组置入时间缩短(P＜0.05)；纤维支气管镜检查分级、气道密封压及咽部不良反应发生率差异无统计学意义(P＞0.05).两组一次置入成功率均大于90％,术中气道管理失败率为0,未见误吸发生；两组置入前后、拔除前后HR及MAP差异无统计学意义(P＞0.05)；术中SpO2、Ppeak、PETCO2均维持在正常范围.结论 喉导管和SLIPA喉罩均可安全有效地用于肥胖患者腹腔镜手术的气道管理,而喉导管更易置入.     

i-gel喉罩用于腹腔镜胆囊手术患者气道管理的效果

目的 评价i-gel喉罩用于腹腔镜胆囊手术患者气道管理的效果.方法 择期全麻下拟行腹腔镜胆囊手术患者120例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄34～62岁,体重45～90 kg,随机分为2组(n=60):ProSeal喉罩组(P组)和i-gel喉罩组(Ⅰ组).根据体重选择喉罩型号,麻醉诱导后置入喉罩,行机械通气,并经引流管放置胃管.记录喉罩置入次数、喉罩及胃管置入情况、纤支镜检查评分,测定喉罩密封压,观察术中口咽部漏气、低氧血症的发生情况.术中监测SpO2、PETCO2、气道峰压,观察拔除喉罩后恶心、呕吐、呛咳、声嘶、咽喉痛、返流误吸的发生情况,记录麻醉时间、手术时间、拔除喉罩时间及苏醒时间.结果 两组麻醉时间、手术时间、拔除喉罩时间及苏醒时间差异无统计学意义(P＞0.05).两组术中SpO2、PETCO2、气道峰压均在正常范围内.与P组比较,Ⅰ组喉罩首次置入成功率和纤支镜检查评分升高,喉罩置入时间缩短(P＜0.05).两组喉罩和胃管置入成功率均为100%;Ⅰ组和P组喉罩密封压比较差异无统计学意义(P＞0.05);Ⅰ组咽喉痛发生率低于P组(P＜0.05),恶心呕吐、呛咳发生率差异无统计学意义(P＞0.05),两组无一例发生声嘶、返流误吸.结论 i-gel喉罩易于置入,气道密封性可靠,通气效果好,不良反应少,可安全有效地用于腹腔镜胆囊手术患者的气道管理.     

双管喉罩与标准型喉罩用于妇科腹腔镜麻醉的比较

目的 比较双管喉罩(PLM)与标准型喉罩(CLM)用于妇科腹腔镜麻醉的实用性和安全性.方法 100例妇科腹腔镜择期患者随机分成PLM组(P组)和CLM组(L组),每组50例.观察两组插入时间与成功率、肺通气情况、气道密封压值、胃胀气情况、注意反流、拔管情况和术后有无咽痛.结果 P组平均置入时间明显长于L组(P＜0.05),P组首次置入成功率明显高于L组(P＜0.05).P组肺通气满意度、气道密封压明显优于L组(P＜0.05);结论与CLM相比,PLM增加插入成功率,能最大程度减少反流误吸风险,改善气道密封,减少漏气,术后并发症少.     

妇科手术患者Guardian喉罩与Supreme喉罩气道管理效果的比较

目的 比较Guardian喉罩与Supreme喉罩用于妇科手术患者气道管理的效果.方法 择期全麻下行妇科手术患者120例,年龄19～80岁,体重50～70kg,ASA分级Ⅰ或Ⅱ级,随机分为2组:Supreme喉罩组(S组,n=59)和Guardian喉罩组(G组,n=61).麻醉诱导后置入4号喉罩,行机械通气.术中监测BP、HR、SpO2、PETCO2和Ppeak.记录喉罩置人情况、置入时间、纤维支气管镜检查分级、气道密封压、正常通气时(VT 8 ml/kg)的气道压、大潮气量(VT20 ml/kg)通气试验时的气道压和漏气的发生情况、术中口咽部漏气的发生情况、拔除喉罩时不良反应和术后咽喉部不良反应的发生情况、麻醉时间、手术时间、喉罩拔除时间和苏醒时间.结果 两组喉罩置入成功率、置入时间、正常通气时的气道压、大潮气量通气试验时的气道压、拔除喉罩时罩体带血和术后咽喉疼痛、声音嘶哑和吞咽困难的发生率、麻醉时间、手术时间、喉罩拔除时间和苏醒时间差异无统计学意义(P＜0.05).两组患者BP、HR、SpO2、Ppeak和PETCO2均在正常范围内.与S组比较,G组纤维支气管镜检查分级和气道密封压升高,大潮气量通气试验时漏气和术中口咽部漏气的发生率降低(P＜0.01).结论 Guardian喉罩和Supreme喉罩置入简单易行,气道密封效果好,可有效保证通气,对咽喉部的刺激小.Guardian喉罩用于妇科手术患者气道管理的效果更好.     

腹腔镜胆囊切除术患者ALMA喉罩和Supreme喉罩气道管理效果的比较:多中心、随机、对照研究

目的 比较ALMA喉罩和Supreme喉罩用于腹腔镜胆囊切除术患者气道管理的效果.方法 本研究为多中心、随机、对照研究.择期行腹腔镜胆囊切除术患者240例,ASA分级Ⅰ级或Ⅱ级,年龄18～64岁,体重50～70 kg,采用随机数字表法,将患者随机分为2组(n=120):Supreme喉罩组(S组)和ALMA喉罩组(A组).两组麻醉诱导后分别置入4号Supreme喉罩或ALMA喉罩,罩囊内注气后通过引流管漏气试验、胸骨上窝按压试验和胃管置入试验检查喉罩是否对位良好,对位良好后行机械通气.喉罩置入成功后行纤维支气管镜检查分级.记录喉罩置入成功情况、置入时间、气道密封压、口咽部漏气、拔除时间、苏醒时间、拔除喉罩时罩体带血和返流及术后咽喉部不良反应的发生情况.对气道管理效果和喉罩放置难易程度进行评分.结果 与S组比较,A组喉罩置入时间延长,气道密封压、纤维支气管镜检查分级、气道管理效果评分升高,口咽部漏气发生率降低(P＜0.05),喉罩置入成功率、引流管漏气率、胸骨上窝波动率、胃管置入成功率、喉罩置入难易程度评分、罩体带血、返流发生率、术后咽喉部不良反应发生率、喉罩拔除时间、苏醒时间比较差异无统计学意义(P＞0.05).结论 ALMA喉罩和Sureme喉罩用于腹腔镜胆囊切除术患者均可有效通气,ALMA喉罩气道管理的效果更好.     

置入食管引流型喉罩和经典喉罩对小儿伤害性刺激程度的比较

目的 比较置入食管引流型喉罩(PLMA)与经典喉罩(CLMA)对小儿伤害性刺激的程度.方法 择期全麻手术患儿47例,性别不限,年龄3-12岁,体重11-36 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患儿随机分为PLMA组(n=23)和CLMA组(n=24).采用序贯法进行试验,靶控输注异丙酚行麻醉诱导,待效应室浓度与预设的血浆靶浓度平衡后置入喉罩.PLMA组和CLMA组首例患儿异丙酚血浆靶浓度分别设为6.0和4.4 μg/ml,存在喉罩置入反应,则下一例患儿异丙酚血浆靶浓度升高1个浓度梯度,无喉罩置入反应,则下一例患儿异丙酚血浆靶浓度降低1个浓度梯度,浓度梯度为0.2 μg/ml.喉罩置入反应的标准为:下颌松弛困难无法置入、置入即刻、置往后1 min内出现呛咳、吞咽、肢体运动、屏气或喉痉挛.计算异丙酚抑制喉罩置往反应的半数有效血浆靶浓度及其95％置信区间.结果 异丙酚抑制小儿PLMA和CLMA置入反应的半数有效血浆靶浓度及其95％置信区间分别为5.87(5.62～ 6.11)和4.53(4.38 ～ 4.69)μg/ml,差异有统计学意义(P＜0.01).结论 置入PLMA对3～12岁小儿的伤害性刺激程度较CLMA增强.     

Supreme喉罩用于腹腔镜手术患者气道管理的效果

目的 评价Supreme喉罩用于腹腔镜手术患者气道管理的效果.方法 择期全麻下行腹腔镜手术的患者120例,性别不限,年龄35～60岁,体重48～85 kg,ASA Ⅰ或Ⅱ级,Mallampatis Ⅰ～Ⅲ级,随机分为2组(n=60):Supreme喉罩组(S组)和气管插管组(T组).S组根据患者体重选择喉罩型号,麻醉诱导后置入喉罩,并经引流管放置胃管,T组在直接喉镜下行气管插管.记录气管插管或喉罩置入时间及置人情况;记录S组胃管置入状况和喉罩气道密封压,并行纤维支气管镜检查评分,以评价喉罩对位情况;记录术中SpO2、PrrCO2和气道峰压(Ppeak),记录拔除气管导管或喉罩后不良反应的发生情况;记录手术时间、麻醉时间、拔管时间和苏醒时间.结果 与T组比较,S组喉罩置入时间、拔管时间和苏醒时间缩短,拔除喉罩后低氧血症、呛咳、咽喉痛的发生率降低(P<0.05);两组均无返流误吸发生.各时点spO2、PETCO2、Ppeak均在正常范围内,组间比较差异无统计学意义(P>0.05).S组喉罩置入成功率和T组气管插管成功率比较差异无统计学意义(P>0.05),S组喉罩气道密封压为(25±4)cm H2O,喉罩对位准确率95%,胃管放置成功率100%.结论 Supreme喉罩通气效果好,气道密封性可靠,拔除后不良反应少,可安全有效地用于腹腔镜手术患者的全麻气道管理.     

The size 1(1/2) ProSeal laryngeal mask airway in infants: a randomized, crossover investigation with the Classic laryngeal mask airway

Many problems with the Classic laryngeal mask airway (CLMA) in infants are believed to be related to its inadequate cuff design. One of the main limitations of the CLMA is that the resulting low-pressure seal can be inadequate for positive pressure ventilation (PPV). The ProSeal LMA (PLMA), a new laryngeal mask airway with a modified cuff, has been shown to form a more effective seal than the CLMA in children. The first infant size PLMA, size 1(1/2), became available recently. We studied 30 anesthetized, nonparalyzed infants aged 15 mo (2-30 mo) and weighing 9 kg (5-12 kg). The CLMA and PLMA were inserted in random order into each patient. Airway leak pressure and maximum tidal volume were measured. Ease of insertion, quality of initial airway, and fiberoptic position were also determined. Gastric tube placement was assessed for the PLMA. The mean airway leak pressure in neutral head position (26.7 versus 18.9 cm H2O), maximum flexion (35.6 versus 28.2 cm H2O), and the mean maximum tidal volume (312 versus 260 mL) were significantly higher for the PLMA (P < 0.01). Air entered the stomach in eight patients with the CLMA but did not with the PLMA. Gastric tube placement was possible in all but one patient. In three patients, the use of the PLMA led to some degree of clinically relevant compression of the larynx. The size 1(1/2) PLMA seems to be a more suitable device for airway maintenance in infants than the same size CLMA. The ability to insert a gastric tube at the same time, and a significantly higher airway leak pressure than with the CLMA, may have important implications for its use for PPV in infants.     

A randomized study to compare ProSeal laryngeal mask airway with classic laryngeal mask airway in anesthetized patients

BackgroundTo overcome the problem of gastric content regurgitation, a device with drain tube and better airway sealing has been made: the ProSeal laryngeal mask airway (PLMA). We aimed to compare the clinical performance of the classic LMA with the PLMA. Several studies comparing these two devices have been done.Our study was designed to compare ease of insertion, airway sealing pressure, and fiber-optic assessment of positioning in adult patients, and we hopes to prove that PLMA is better to LMA in all these aspects. We hypothesized that PLMA would have a better leak pressure than the CLMA and minimum difference in leak pressure of 20% between them was considered clinically significant.Material and methodsOne hundred adult patients of either sex between age group of 18–65 years scheduled for elective surgery were included in the study. Patients were randomly allocated to two groups of 50 patients each. In group I CLMA and in group II PLMA were used. The number of attempts, ease of insertion, time of insertion, and failure if occurred were noted down. Hemodynamic changes, airway sealing pressure, and the fiber-optic were also recorded.ResultsData thus compiled showed that insertion was successful in first attempt in 94% cases with LMA as well as PLMA. The time taken for successful placement of LMA and - PLMA was 15 and 17 s, respectively. Sealing pressure was higher for group II at all cuff volumes. More number of patients (89%) in group II had a fiber optic score of I and II as compared to group I which had 81% patients with score I and II.ConclusionWe conclude that PLMA is easy to insert with a short insertion time, high success of placement at first attempt, and capable of achieving a more effective seal than LMA.     

The ProSeal laryngeal mask airway: A randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients

BACKGROUND: The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff to improve seal and a drainage tube to provide a channel for regurgitated fluid and gastric tube placement. In the present randomized, crossover study, the authors tested the hypothesis that ease of insertion, airway sealing pressure, and fiberoptic position differ between the PLMA and the standard laryngeal mask airway (LMA). For the PLMA, we also assess ease of gastric tube placement and the efficacy of an introducer tool. METHODS: Sixty paralyzed, anesthetized adult patients were studied. Both devices (only size 4) were inserted into each patient in random order. Airway sealing pressure and fiberoptic position were determined during cuff inflation from 0 to 40 ml in 10-ml increments. Gastric tube insertion was attempted with the PLMA if there was no gas leak from the drainage tube. In 60 additional patients, ease of insertion for the PLMA was compared with and without an introducer. RESULTS: First-time success rates were higher (60 of 60 vs. 52 of 60; P = 0.003) and the effective airway time shorter (9 +/- 3 s vs20 +/- 18 s; P < 0.0001) for the LMA. There were no failed uses of either device within three attempts. Airway sealing pressure was 8-11 cm H2O higher for the PLMA at all cuff volumes (P < 0.00001) and was higher in females for both devices. Fiberoptic position was better with the LMA at all cuff volumes (P < 0.00001), but vocal cord visibility was similar (LMA, 59 of 60; PLMA, 56 of 60). For the PLMA, gastric tube placement was successful in 58 of 58 patients and took 9 +/- 5 s. First-time success rates were higher (59 of 60 vs53/60; P = 0.03) and the effective airway time shorter (15 +/- 13 s vs 23 +/- 18 s; P = 0.008) with the introducer. CONCLUSION: The PLMA is capable of achieving a more effective seal than the LMA and facilitates gastric tube placement, but it is more difficult to insert unless an introducer tool is used. When correctly positioned, the PLMA isolates the glottis from the upper esophagus with possible implications for airway protection.     

妇科腹腔镜手术患者双管喉管和双管喉罩通气效果的比较

目的 比较双管喉管和双管喉罩用于妇科腹腔镜手术的通气效果.方法 拟行妇科腹腔镜手术患者50例,ASA Ⅰ或Ⅱ级,体重指数＜30 kg/m2,随机分为2组(n=25),双管喉管组(L组)和双管喉罩组(P组).两组均靶控输注异丙酚(血浆靶浓度3～5 μg/ml)和瑞芬太尼(血浆靶浓度4～6 ng/ml),静脉注射维库溴铵0.1 mg/kg,待BIS40～60时置人适宜型号的双管喉管或双管喉罩,置入成功后应用纤维支气管镜观察口咽部解剖结构显露分级情况.记录双管喉管或双管喉罩置入时间、一次置人情况和气道密封压.术中持续监测HR、SP、DP、MAP、SpO2、气道峰压(Ppeak)和呼气末二氧化碳分压(PETCO2),记录手术时间、气腹时间、清醒时间、拔除时间及术后24 h内咽部不良反应发生情况.结果 两组置入时间、一次置入成功率、气道密封压、手术时间、气腹时间、清醒时间、拔除时间及术后24 h内咽部不良反应发生率比较差异均无统计学意义(P＞0.05).两组术中血液动力学平稳,SpO2、Ppeak和PETCO2均在正常范围,且差异无统计学意义(P＞0.05).与L组比较,P组纤维支气管镜下口咽部解剖结构更清晰(P＜0.01).结论 双管喉管可有效地用于妇科腹腔镜手术,安全性良好,其通气效果与双管喉罩无差异.     

SLIPA喉罩对腹腔镜胆囊切除术围拔管期躁动及血流动力学的影响

目的 比较腹腔镜胆囊切除术应用SLIPA喉罩和气管导管行全麻通气对拔管期躁动及血流动力学的影响.方法 将腹腔镜胆囊切除术患者60例随机分为喉罩组和气管导管组,每组30例.两组患者均用咪达唑仑+异丙酚+舒芬太尼+顺式阿曲库铵静脉诱导,麻醉诱导后喉罩组插入SLIPA喉罩,气管导管组插入气管导管.比较两组患者拔管期血流动力学变化、躁动评分及不良反应发生例数.结果 喉罩组躁动评分显著低于气管导管组(P<0.05),两组患者血流动力学变化差异有统计学意义(P<0 05);气管导管组苏醒后30 min自诉喉部不适例数多于喉罩组(P<0 05).结论 全麻下腹腔镜胆囊切除术采用SLIPA喉罩通气比气管插管通气在拔管期循环动力学更稳定,患者耐受程度好,安全有效.     

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

PURPOSE: To determine whether a functional difference exists between the size 2 laryngeal mask airway (LMA)-Classic (CLMA) and LMA-Proseal (PLMA) in anesthetized children who have received neuromuscular blockade. Airway leak during intermittent positive pressure ventilation (IPPV) and adequacy of fibreoptic laryngeal view were the primary study outcomes. METHODS: A randomized, controlled, single-blinded study of 51 ASA I or II children weighing 10-20 kg was undertaken. The anesthetic technique was standardized. Following insertion of the LMA and cuff inflation to 60 cm H(2)O, we measured oropharyngeal leak pressure and gastric insufflation and leak fraction during IPPV, and evaluated the adequacy of fibreoptic view. RESULTS: Oropharyngeal leak pressure measured by neck auscultation was higher for the PLMA compared to the CLMA (23.7 vs 16.5 cm H(2)O, P = 0.009) but, when measured by the inspiratory hold maneuver was not significantly different (24.8 vs 20.3 cm H(2)O, respectively, P = 0.217). Leak fraction values were similar for the CLMA and the PLMA (21.2%. vs 13.3%, respectively, P = 0.473). A satisfactory view of the larynx was obtained more frequently in the PLMA group (21/25 vs 10/25, P = 0.003). Gastric insufflation during leak determination was more common with the CLMA (12/26 vs 2/25 CLMA vs PLMA, respectively, P = 0.006). CONCLUSION: In children undergoing IPPV with neuromuscular blockade, the size 2 PLMA is associated with a higher leak pressure by auscultation and less gastric insufflation compared to the CLMA. Leak pressures assessed by manometric stability are similar with these two devices. The improved fibreoptic view of the larynx through the PLMA may be advantageous for bronchoscopy.     

改良Proseal喉罩与改良普通喉罩在无痛纤维支气管镜检查中的气道管理

目的比较改良Proseal喉罩和改良普通喉罩在无痛纤维支气管镜检查中气道管理的效果。方法选择行纤维支气管镜检查患者40例,随机均分为两组:改良Proseal喉罩组(P组)和改良普通喉罩组(L组)。全麻诱导后徒手插入喉罩,接麻醉机,控制或辅助通气。记录两组麻醉前(T0)、插入喉罩即刻(T1)、插入喉罩3min(T2)的SBP、DBP、HR和SpO2,同时记录喉罩插入时间和并发症,并进行喉罩通气评估、纤维支气管镜评估和气道密封压测定。结果两组患者喉罩插入时间及各时点的SBP、DBP、HR和SpO2差异均无统计学意义;P组气道密封压明显高于L组(P<0.01);P组喉罩通气、纤维支气管镜评分优良率均为100%,明显高于L组的85%、80%(P<0.01);术毕P组1例喉罩粘血,明显少于L组的7例(P<0.05)。结论改良Proseal喉罩在气密性、通气评估、纤维支气管镜评估等方面好于改良普通喉罩,但对血流动力学的影响两者无明显差异。