关键词: 三通喉罩, 局麻, 静脉全麻, 纤支镜检查

Abstract:

Objective: To investigate the safety and feasibility of three-way laryngeal mask airway used in painless fibreoptic
bronchoscopy. Methods: Patients aged under 65 years old and ASA I~II were divided into intravenous anesthesia group（IA，n=19）and local anesthesia group（LA，n=20）according to the principle of voluntary. Patients in group LA were intramuscular injection with luminal 100 mg and atropine 0.5 mg 30 minites before operation. Then 3 mL lidocaine was injected via cricothyroid membrane pre-operation. Patients in group IA were inserted with three-way laryngeal mask airway after rapid induction of anesthesia. SBP,DBP, HR, and SPO2 were recorded at the moments in pre-anesthesia（T0）, fibreoptic bronchoscopy through the glottis（T₁）, perform a biopsy（T₂）, 5 minutes after-operation（T₃）. The hypoxic events, check time and wake time were recorded during operation. Results: All patients finished painless fibreoptic bronchoscopy successfully, had stable hamodynamics, no side effect and complications in any cases（P<0.05）. In group IA, satisfaction from patients and endoscopic physicians was high. Conclusion: Three-way laryngeal mask airway under intravenous anesthesia in painless fibreoptic bronchoscopy is a simple and safe method. The use of TLMA can satisfy the anesthesiologist and endoscopic physicians to airway management needs at the same time. It may obtain the respiratory control power,guarantee good ventilation and oxygen supply, and considerably improve the safety of anesthesia.

Key words: three-way laryngeal mask airway（TLMA）, local anesthesia, intravenous anesthesia, fibreoptic bronchoscopy