腹腔镜手术全麻诱导胃胀气研究进展

Research Progress on Gastric Insufflation during Induction of General Anesthesia in Laparoscopic Surgery

腹腔镜手术常采用全身麻醉,在麻醉诱导后气管管前通常都会对病人进行面罩正压通气供氧,不恰当的通气方式极大增加了气体进入胃致胃胀气的概率,由此导致麻醉诱导期成为整个围手术期中最容易发生胃胀气的阶段。严重的胃胀气不仅增加了麻醉过程中反流误吸风险、而且还对手术及术后恢复造成不利影响。对此,国内外已有许多学者做了相关研究,通过使用不同的通气方式或施加特殊干预措施,甚至是避免进行正压通气以减少胃胀气的发生。本文介绍了胃胀气的产生机制、不良影响及常用胃胀程度评估方法 ,对近年来麻醉诱导时避免胃胀气产生的各种方法进行总结和探讨,以便读者对腹腔镜手术中的胃胀气有一个整体的认识。General anesthesia is often used in laparoscopic surgery, after induction of anesthesia, patients are usually given mask positive pressure ventilation for oxygen supply before endotracheal intubation. Improper ventilation greatly increases the probability of gas entering the stomach and causing gastric insufflation, thus making the induction period of anesthesia the stage most prone to bloating during the whole perioperative period. Severe gastric insufflation not only increases the risk of reflux aspiration during anesthesia, but also adversely affects the operation and postoperative recovery. In this regard, many scholars at home and abroad have done relevant research, by using different ventilation methods or applying special intervention measures, or even avoiding positive pressure ventilation to reduce the occurrence of gastric insufflation. This paper introduces the mechanism, adverse effects and common methods of evaluating the degree of gastric insufflation, summarizes and discusses various methods to avoid bloating during anesthesia induction in recent years, so that readers can have an overall understanding of gastric insufflation during laparoscopic surgery.