全麻诱导不同通气方式对胃胀气的影响

Ultrasound assessment on gastric insufflation by different general anesthesia induction methods

目的:探讨全麻诱导时不同气道压力、呼吸频率下控制性通气对胃胀气的影响。方法:选择40例择期全麻患者随机分为15cmH_2O压力组(P15组)和10cmH_2O压力组(P10组)。全麻诱导依次静脉给予丙泊酚,舒芬太尼,顺式阿曲库铵,1min后双手托下颌面罩加压用麻醉机的压力通气模式辅助通气2min。记录通气30、60、90、120s时的呼吸参数(SPO_2、P_(ET)CO_2),使用超声监测仪在诱导前及诱导后测量胃窦长短径并计算出胃窦面积。结果:两组的胃窦面积与通气前相比都有所增加,但P15组差异有统计学意义;两组患者诱导期间的气道压力峰值与所设定的基本一致,P_(ET)CO_2、SPO_2数值差异无统计学意义。结论:全麻诱导期应用顺式阿曲库铵在压力控制模式下的通气10cmH_2O(10次/min)压力组可以在保障通气的情况下减少胃胀气的发生。

Objective:To observe the influence of gastric insufflation in two different general anesthesia induction methods by ultrasonography of antrum.Methods:Forty female patients undergoing elective operation, were randomly assigned to two groups according to facemask ventilation pressure: 15 cmH2O,15 times/min(group P15),10 cmH2O,10 times/min(group P10)with twenty in each group.Patients were injected with propofol,sufentanil, cis-atracurium for general anesthesia induction.after 1 minute , face-mask pressure controlled ventilation for 2 minutes.Respiration parameters were recorded on 30 s(T1 ),60 s(T2 ), 90 s(T3 ),120 s(T4 ).The cross-sectional antral area was calculated by measured transverse and longitudinal diameter using ultrasonography before and after facemask ventilation .Results:There was no significant different in respiratory parameters between the groups.The cross-sectional antral area was increased in each group but group P15 has significant difference. Conclusion:Face-mask pressure controlled ventilation during anesthesia induction,10 cmH2O (10 times/min)can guarantee adequate ventilation and relieve gastric insufflation.