摘要
目的通过超声监测评估全麻诱导时不同的通气压力对幼儿胃胀气的影响。方法选择择期行气管内麻醉患儿60例,年龄1-3岁,BMI〈22kg/m2,ASAⅠ级,根据全麻诱导去氮供氧时的通气压力将患儿随机均分为三组：10cm H2O通气组（P10组）、15cm H2O通气组（P15组）和20cm H2O通气组（P20组）。依次静脉推注丙泊酚2mg/kg、芬太尼0.002 mg/kg、顺式阿曲库铵0.15mg/kg行全麻诱导,待意识消失后,压力控制面罩通气120s。记录意识消失后即刻（T0）、面罩通气30s（T1）、60s（T2）、90s（T3）、120s（T4）及插管后即刻（T5）的呼吸参数（SpO2、PETCO2）,使用超声监测仪在T0及T4时齐腹主动脉与肝左缘水平采集胃窦部横纵径计算截面面积。结果三组患儿所有观测时点的SpO2≥99%。T1-T5时三组PETCO2明显高于T0时,T5时三组PETCO2明显高于T4时（P〈0.05）;T5时P10组PETCO2高于45 mm Hg,而P15组和T5时P20组PETCO2低于45mm Hg。P20组面罩正压通气后胃窦部面积明显大于面罩通气前（P〈0.05）。结论幼儿全麻诱导去氮供氧时,面罩通气压力为15cm H2O可保证通气效果,又可避免发生胃胀气。
Objective To observe of different facemask pressure controlled ventilation yongon gastric insufflation evaluated by ultrasound in infants during anesthesia induction.Methods Sixty ASA Ⅰinfants aged 1-3yr,undergoing elective surgery,were randomly assigned to three groups according to facemask ventilation pressure：10cm H2O（P10）,15 cm H2O（P15）and 20 cm H2O（P20）with twenty in each group.Infants were injected with propofol 2 mg/kg,fentanyl 0.002 mg/kg,cis-atracurium 0.15 mg/kg for general anesthesia induction until consciousness lost,then facemask pressure controlled ventilation was applied for 120 s.Some respiratory parameters（SpO2,PETCO2）were recorded at the time of loss of consciousness（T0）and after facemask pressure controlled ventilation for 30s（T1）,60s（T2）,90s（T3）,120s（T4）and after tracheal intubation（T5）.The cross-sectional transverse and longitudinal diameter and area were measured respectively using ultrasound at T0 and T4.Results In all groups,SpO2 was greater than or equal to 99% at all time points.PETCO2 at T1-T5 was significantly higher than that at T0 and PETCO2at T5 was higher than that at T4 in all three groups.There were statistically significant increases in the values of the antral cross sectional area before and after facemask pressure controlled ventilation in group P20（P0.05）.Conclusion During anesthesia induction in infants,15 cm H2O facemask ventilation pressure can guarantee adequate ventilation,and avoid gastric insufflation.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2016年第3期230-233,共4页
Journal of Clinical Anesthesiology
关键词
胃胀气
气道管理
儿童
超声测量
Gastric insufflations
Airway Management
Children
Ultrasonographic measurement
