关键词: 喉罩麻醉, 气管插管麻醉, 手汗症, 微创手术, 快速康复

Abstract: Objective　To compare and analyze the clinical effects of laryngeal mask anesthesia and endotracheal intubation anesthesia in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. Methods　It was a case control study. The clinical data of 80 patients with severe palmar hyperhidrosis who underwent minimally invasive surgery in the department of cardiothoracic surgery of Jieyang People's Hospital from January 2017 to October 2021 were retrospectively analyzed. They were divided into two groups, undergoing laryngeal mask anesthesia (group Ⅰ, 40 cases) and endotracheal intubation anesthesia (group Ⅱ, 40 cases) respectively. There were 21 males and 19 females in group Ⅰ, aged (20.8±4.6) years; there were 17 males and 23 females in group Ⅱ, aged (20.9±4.7) years. The total hospital stay, postoperative hospital stay, anesthesia cost, hospitalization cost, visual field exposure score, anesthetic effect score, operation time, anesthesia time, incidence of postoperative complications, and other indicators were compared. Independent sample t test was used for the measurement data conforming to normal distribution, rank sum test was used for the measurement data conforming to abnormal distribution or the grade data, and Chi-square test or Fisher's exact probability method was used for the count data. Results　The total length of stay in group Ⅰ was 2.0 (2.0, 2.0) d, the postoperative length of stay was 1.0 (1.0, 1.0) d, the anesthesia cost was (2 442.9±420.2) Yuan, the total hospitalization cost was (10 848.2±1 238.4) Yuan, and the anesthesia time was (75.1±18.0) min, the total length of stay in group Ⅱ was 3.0 (3.0, 4.0) d, the postoperative length of stay was 2.0 (2.0, 3.0) d, the anesthesia cost was (2 883.7±242.3) Yuan, the total hospitalization cost was (12 739.5±917.1) Yuan, and the anesthesia time was (97.9±23.1) min, the above indexes in group Ⅰ were better than those in group Ⅱ, and the incidence of throat pain in group Ⅰ was significantly lower than that in group Ⅱ, with statistically significant differences (all P<0.05). There were no statistically significant differences in the visual field exposure score, anesthetic effect score, operation time, and incidences of other postoperative complications between the two groups (all P>0.05). Conclusions　Laryngeal mask anesthesia is safe and effective in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. It is suitable for accelerated rehabilitation surgery after minimally invasive surgery for palmar hyperhidrosis.

Key words: Laryngeal mask anesthesia, Endotracheal intubation anesthesia, Palmar hyperhidrosis, Minimally invasive surgery, Rapid rehabilitation