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目的：对照研究喉罩与气管插管全凭七氟醚吸入麻醉用于小儿眼科短小手术的优缺点。方法：选取2012 年1 月至2013 年 12 月于我院行行眼科手术的ASAⅠ～Ⅱ级小儿共80 例，随机分为喉罩组（40 例）和气管插管组（40 例）两组，所有患儿均给予全凭七氟醚吸入麻醉，喉罩组采用喉罩通气，而气管插管组则采用气管插管通气。监测T1(诱导后下颌松弛)、T2(喉罩置入或气管插管后1min)、T3(喉罩或气管插管拔出前)、T4(喉罩或气管插管拔出后1min)四个时间点的血流动力学指标并记录两组患儿置入喉罩或气管插管的次数、手术时间、手术结束至拔除喉罩或气管插管的时间，以及可能产生的不良反应。结果：喉罩组血流动力学指标在四个测量时间点的差异均无统计学意义（P>0.05）；气管插管组血流动力学指标在四个测量时间点的差异均有统计学意义（P<0.05），其中T2 时间点均高于T1 时间点，T4 时间点均高于T1、T3 时间点。两组患儿置入喉罩或者气管插管次数、手术时间、手术结束至拔除喉罩或者气管插管时间的差异均无统计学意义（P>0.05）；气管插管组患儿发生呛咳的比例高于喉罩组，差异有统计学意义（P<0.05）；气管插管组患儿发生呛咳的比例高于喉罩组，差异有统计学意义（P<0.05）。结论：喉罩复合全凭七氟醚吸入麻醉可安全有效地应用于小儿眼科短小手术。

英文摘要:

Objective:To compare the advantage and adverse reaction of largneal mask and trachea cannula combine with sevoflurane inhalation anesthesia in infant undergoing short eye surgery.Methods:80 infants who were given ASAⅠ-Ⅱ eye surgery in our hospital fromJanuary 2012 to December 2013, were devided into largneal mask group(40cases) and trachea cannula group (40 cases) randomly, both groups were given sevoflurane inhalation anesthesia, largneal mask was given to largneal mask group and trachea cannula was given to trachea cannula group to keep breath. The hemodynamic indexes were monitored at four time points: T1 (mandible relaxation after induction), T2 (1 min after laryngeal mask placement or endotracheal intubation), T3 (before pulling out the laryngeal mask or endotracheal intubation), and T4 (1 min after laryngeal mask placement or endotracheal pull out). The time of laryngeal mask placement or endotracheal intubation, the time of operation, the time of Laryngeal mask or endotracheal intubation pull out after operation, and the adverse reaction of Laryngeal mask or endotracheal intubation pull in and pull out were recorded.Results:The hemodynamic indexes for the four time points in largneal mask group showed no statistically significant difference (P>0.05). The hemodynamic indexes for the four time points in trachea cannula group showed statistically significant difference (P<0.05) , the indexes at T2 time point were higher than those at T1 time point, and at T4 time point were higher than those at time points T1 and T3. The time of laryngeal mask placement or endotracheal intubation, the time of operation, the time of pulling out the laryngeal mask or endotracheal intubation after operation of two groups showed no statistically significant difference (P>0.05), the proportion of bucking for trachea cannula group was higher than for largneal mask group, and the difference was statistically significant (P<0.05).Conclusion:Largneal mask combined with sevoflurane inhalation anesthesia could be used in infants undergoing short eye surgery safely and effectively.

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