Journal of Hebei Medical University

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The application of laryngeal mask  airway combined with bronchial blocker in myasthenia gravis patients undergoing thoracoscopic thymectomy#br#

  

  1. Department of Anesthesiology, the First Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050011, China
  • Online:2018-12-25 Published:2018-11-30

Abstract: [Abstract] Objective〖HTSS〗〓To  evaluate  the feasibility of application of  laryngeal  mask combined with bronchial  blocker  for  thoracoscopic thymectomy  in  myasthenia  gravis patients.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixteen patients with myasthenia gravis type Ⅰ or type ⅡA, scheduled for thoracoscopic thymectomy,were divided into endotracheal tube bronchial blocker group(group T) and laryngeal mask plus bronchial blocker group(group L)(n=8 each) using a random number table. Midazolam 0.04 mg/kg, sufentanil 0.3-0.4 μg/kg, propofol 1-2 mg/kg and cisatracurium 0.1 mg/kg were injected intravenously for induction of anesthesia. endotracheal tube with a bronchial blocker was intubated in group T, Patients in the group L was placed laryngeal mask followed by a bronchial blocker, and the accuracy was assessed by using a flexible fiberoptic bronchoscopy. Blood pressure and heart rate were recorded  before anesthesia induction and endotracheal intubation, and the different values(△BP and △HR) were calculated. The arterial blood samples 1ml were collected for blood gas analysis at 10 min after one lung ventilation. The partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), and peak airway pressure(Ppeak) were recorded , and the dynamic compliance(Cdyn) was calculated. Intraoperative pulmonary collapse was observed. The patients were followed up 6 hours after operation to record whether there were complications such as sore throat, nausea and vomiting.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with groupT, the △BP and △HR were lower in group L(P<005). There were no significant differences between the two groups in PaO2, PaCO2, Ppeak,Cdyn,the quality of lung collapse, and the incidences of throat pain, nausea and vomiting(P>005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓laryngeal mask plus bronchial  blocker may be considered an alternative onelung ventilation technique, which can be used in thoracoscopic myasthenia gravis surgery.

Key words: myasthenia gravis; thoracoscopy; laryngeal mask, bronchial blocker