食管癌根治术患者麻醉诱导后预置鼻咽通气道的效果

Effect of preplaced nasopharyngeal airway after anesthesia induction in patients undergoing radical surgery of esophageal cancer

目的评价鼻咽通气道用于食管癌手术患者麻醉苏醒期气道管理的效果。方法将96例择期接受全身麻醉的食管癌根治术患者,随机分为研究组和对照组各48例。对照组转入PACU给予3 L/min面罩吸氧;研究组在麻醉诱导后置入鼻咽通气道,术毕转入PACU经鼻咽通气道给予3 L/min吸氧。观察并记录患者入手术室(T0)、入PACU时(T1)、拔除气管导管时(T2)、拔除气管导管后10 min(T3)、拔除气管导管后30 min(T4)、转出PACU时(T5)脉搏氧饱和度,T0、T3、T5时患者动脉血气分析结果,PACU内患者躁动、恶心呕吐和喉痉挛等并发症。结果两组血氧饱和度、氧分压和二氧化碳分压组间效应、时间效应、交互效应显著(均P<0.05),研究组T3、T4、T5血氧饱和度显著高于对照组,T3、T5的氧分压显著高于对照组,二氧化碳分压显著低于对照组(均P<0.05)。结论食管癌根治术患者预置鼻咽通气道能降低麻醉恢复期低氧血症发生率,改善患者上呼吸道通气效果。

Objective To evaluate the effect of nasopharyngeal airway on airway management in patients undergoing radical surgery of esophageal cancer during anesthesia recovery.Methods A total of 96 patients undergoing radical surgery of esophageal cancer under general anesthesia were randomized into an intervention group and a control group,with 48 cases in each group.The control group was transferred to the PACU and given 3 L/min oxygen through a face mask,while in the intervention group,the nasopharyngeal airway was placed through the nasal cavity after anesthesia induction,through which oxygen was inhaled 3L/min in PACU after surgery.The SpO_(2) were recorded at the following 5 time points:entering the operating room(T0),entering the PACU(T1),removing the endotracheal tube(T2),10 minutes after removing the endotracheal tube(T3),30 minutes after removing the endotracheal tube(T4),and leaving the PACU(T5).The arterial blood gas analysis results at T0,T3,and T5 were recorded,and the complications such as agitation,nausea,vomiting,and laryngeal spasm were recorded during PACU stay.Results The intervention effect,time effect,time×intervention interaction effect in SpO_(2),PaO_(2) and PaCO_(2) were significant between the two groups(all P<0.05).The SpO_(2) at T3,T4,and T5 in the intervention group were significantly higher than those in the control group,its PaO_(2) at T3 and T5 were obviously higher than those in the control group,and its PaCO_(2) were significantly lower than those in the control group at the two time points(all P<0.05).Conclusion The preplaced nasopharyngeal airway in patients undergoing radical surgery of esophageal cancer can effectively reduce the incidence of hypoxemia during anesthesia recovery,and improve the ventilation of the upper respiratory tract.