Ojective To investigate the effects of laryngeal mask airway with endobronchial blocker on respiratory mechanics in children during one-lung ventilation.
Methods Sixty children undergoing thoracoscopic surgery, 37 males and 23 females, aged 6-10 years, with a BMI of 20-25 kg／m2, falling into ASA physical status Ⅱ, were randomly divided into the laryngeal mask group and the tracheal intubation group, n = 30 in each group. After intubation, patients were ventilated with pressure controlled mode, respiratory parameters were set as follows: airway pressure (P) of 16 cmH2O, respiratory rate of 16 breaths/min, positive end expiratory pressure （PEEP） of 0 cmH2O and I∶ E of 1∶2 in both groups. Hemodynamic parameters and respiratory mechanics were recorded after anesthesia induce (T0), at the beginning of one lung ventilation (T1) and 45 min after one lung ventilation (T2), respectively. Meanwhile, arterial blood gas was analyzed respectively at T2. Side effects such as hypercapnia, hypoxemia, sore throat, laryngospasm and aspiration were also recorded.
Results SBP and DBP in the laryngeal mask group at T1 were significantly lower than those in the tracheal intubation group (P < 0.05). There was no significant difference in SBP, DBP and HR between the two groups at T2. PaO2 in the laryngeal mask group was significantly higher than that in the tracheal intubation group, and PaCO2 was significantly lower than that in the laryngeal mask group at T2(P < 0.05). The VT and CL in the laryngeal mask group were significantly higher, while PETCO2 was significantly lower than that in the tracheal intubation group (P < 0.05). The incidence of hypercapnia in the laryngeal mask group was significantly lower than that in the tracheal intubation group (P < 0.05).
Conclusion The pressure-controlled laryngeal mask airway ventilation can increase tidal volume, improve oxygenation and reduce PETCO2 in children during one-lung ventilation. |
