目的：分析喉罩在肥胖患者眼科日间手术中的应用特点。方法：选择 2021 年 1 月— 2024 年 3 月在中山大学中山眼科中心行日间眼科手术 且体质量指数（body mass index，BMI）≥25 kg/m2的男性患者进行分析，将患者分为2组：超重组（BMI 25~<30 kg/m2）及肥胖组（BMI≥30 kg/m2）。比较两组患者入室时（T1）、诱导后（T2）、喉罩置入后（T3）、手术开始时（T4）、手术开始10 min（T5）、手术结束时（T6）、入麻醉恢复室（post-anesthesia care unit，PACU）（T7）、喉罩拔除时（T8）的血流动力学和血氧饱和度变化情况；并分析喉罩置入后（T3）、手术开始时（T4）、手术开始10 min（T5）、手术结束时（T6）和喉罩拔除时（T8）患者的呼吸参数变化情况，记录两组患者的喉罩通气成功率及复苏室的停留时间。结果：纳入 118 例患者，其中超重组 57 例、肥胖组 61 例。两组均未出现喉罩通气失败病例，肥胖组在T3、T4、T5、T6以及T8等时点气道峰压均高于超重组（P < 0.05）；肥胖组的呼吸道不良事件发生率高于超重组（P < 0.05）。两组患者围术期生命体征平稳（P > 0.05），复苏室停留时间在组间比较差异无统计学意义且均顺利日间手术离院（P > 0.05）。结论：喉罩通气下全身麻醉能安全应用在肥胖患者眼科日间手术中，高BMI与高气道峰压相关。
Objective: General anesthesia using laryngeal mask airway (LMA) ventilation can facilitate ambulatory ophthalmic surgery, however, there remains debates about the use of LMA for obese patients. This study retrospectively analyzed the application of LMA in obese patients for ambulatory ophthalmic surgery. Methods: In this retrospective study, we analyzed all patients with a BMI≥25 kg/m2 who underwent ambulatory ophthalmic surgery under general anesthesia at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2021 to March 2024. The patients were divided into two groups: overweight group (BMI 25~<30 kg/m2)) and obese group (BMI ≥30 kg/m2) . We compared the changes in hemodynamics and oxygen saturation at the several time points, baseline after entering operating room (T1), anesthesia induction (T2), LMA insertion (T3), start of surgery (T4), 10 minutes after surgery (T5), surgery completion (T6), transfer to PACU (T7), and LMA removal (T8);and analyzed the changes in respiratory parameters of the patient at T3, T4, T5, T6, and T8 time points between both groups. We also observed the differences in success rate of LMA insertion and ventilation and PACU stay time as well as time to discharge home between two groups. Results: 118 cases were found suitable for the final analysis and divided into overweight group (n=57) and obese group (n=61). All patients in the two groups uneventfully completed the ophthalmic ambulatory surgery and discharged home under the laryngeal mask airway ventilation, none of patients in both group displayed LMA ventilation failure. The hemodynamics and oxygen saturation in both groups were stable during perioperative period(P > 0.05). The peak airway pressures in obese group were dramatically increased than in overweight group at T3, T4, T5, T6 and T8 time points (P < 0.05), and the incidences of adverse respiratory events in obese group were significant higher than in overweight group （P < 0.05）. The PACU stay time was comparable in both groups (P > 0.05). Conclusion: Laryngeal mask airway (LMA) can be safely used for obese patients undergoing ophthalmic surgery, high BMI is related to high peak airway pressures.
