Laryngeal Mask In Anesthesia In Cerebral Palsychildren With Carotid Sympathetic Nerve Dissection Surger

ObjectiveDiscuss different ways of anesthesia under the microscope Carotid sympathetic decollement outer membrane of the application of safety and reliability, to seek a more suitable for Severe cerebral palsy children anesthesia methods to implement such an operation. MethodsASA Ⅰ level, marked line microscope carotid sympathetic nerve dissection surgery with outer membrane, 60 cases were randomly divided into two pipe laryngeal mask(Pro Seal laryngeal mask airway PLMA) and ordinary endotracheal tube(tracheal catheter TT) in the two groups, 30 cases in each group.Children with routine preoperative fasting water, 30 minutes before anesthesia intramuscular injection atropine 0.01 mg/Kg.Stay between inhaled sevoflurane anesthesia preparation, children consciousness disappears into the operating room, open two way venous channels, regular monitoring of mean arterial pressure,(MAP), heart rate,( HR) and pulse oxygen saturation(SPO2).Continue to mask inhalation sevoflurane, stay with eyelash reflex disappears, intravenous fentanyl injection 2 μg/Kg, vecuronium bromide amine 0.1 mg/Kg.PLMA group into suitable double tube laryngeal mask, TT group take the endotracheal intubation.Observation of children in different time points(T0 before anesthesia induction, T1 before intubation, T2 1 min, T3 3 min after intubation and after intubation tube, T4 drawing before, T5 extubation after 1 min) of mean arterial pressure, heart rate, pulse oxygen saturation and breathing at the end of the carbon dioxide and other vital signs change;Observing children wake up of time, perioperative complications, and 30 minutes after anesthesia in the two groups blood gas changes, and so on and so forth. ResultsBoth groups of children with complete tracheal intubation and laryngeal mask placement, surgery are completed smoothly.Intraoperative complication was not a serious accident, two groups of children with surgical time is not significant.Each time the heart rate, blood pressure comparing PLMA group were not significant(P > 0.05).TT group after intubation and extubation after induced heart rate and blood pressure higher than before, and higher than group PLMA with corresponding point(P < 0.05).Two groups of pulse oxygen saturation(Spo2), breathe out at the end of the co2 partial pressure(PETCO2), arterial blood oxygen partial pressure(Pa O2) compare differences had no statistical significance(P > 0.05).TT group throat discomfort, choking cough, the incidence of complications such as much secretion from above PLMA group(P < 0.05).In the two groups had no reflux, aspiration, laryngospasm, complications such as abdominal distension.Compare of anesthesia waking time two groups was statistically significant, is the shorter of the TT group PLMA group,(P < 0.05). ConclusionThis research through the larger sample size double tube laryngeal mask compared with tracheal intubation in children with prompt PLMA can significantly reduce the induction period, children waking period hemodynamic fluctuations., can improve oxygenation and reduce the awakening period makes, the incidence of laryngospasm, cough.Even if the position changes will not significantly affect the process of operating.Application of the third generation of double tube laryngeal mask anesthesia for children with severe cerebral palsy carotid sympathetic nerve dissection surgery, outer membrane than traditional endotracheal intubation anesthesia on hemodynamics more smoothly and less complications.The third generation of double tube laryngeal mask anesthesia is more suitable for the children carried carotid sympathetic nerve outer membrane stripping operation...