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小儿喉罩气道全身麻醉期间食管pH值的连续监测

Continuous monitoring of oesophageal pH during general anaesthesia with laryngeal mask airway in children.

作者信息

Cebrián J, Avellanal M, Morales J L

机构信息

Department of Anesthesiology and Intensive Care, Gregorio Marañón General Hospital, Madrid , Spain.

出版信息

Paediatr Anaesth. 2000;10(2):161-6. doi: 10.1046/j.1460-9592.2000.00476.x.

Abstract

We studied the incidence of gastro-oesophageal reflux (GOR) during general anaesthesia with the laryngeal mask airway (LMA) in a paediatric population with two ventilatory regimes: spontaneous breathing and controlled mechanical ventilation (CMV). Thirty children between 6 months and 15 years, ASA I-II, for routine surgery, were randomly assigned in two groups: spontaneous ventilation (n=14), and CMV (n=16). A pH probe was situated in the central third of the oesophagus. Some 66% of the patients breathing spontaneously had GOR episodes vs. 92% of the patients with CMV (P < 0,01). Reflux took place mainly after LMA removal (21% vs. 68%; P < 0,01) and in the Postanaesthetic Care Unit (PACU) (29% vs. 43%; P < 0,05). There was a high incidence of GOR during general anaesthesia and in the PACU in paediatric patients anaesthetized with the LMA. GOR episodes were significantly more evident in the CMV group, mainly after LMA removal, but without clinical significance.

摘要

我们研究了在小儿群体中使用喉罩气道(LMA)进行全身麻醉时,采用两种通气模式(自主呼吸和控制机械通气[CMV])下胃食管反流(GOR)的发生率。30名年龄在6个月至15岁、ASA I-II级、接受常规手术的儿童被随机分为两组:自主通气组(n = 14)和CMV组(n = 16)。在食管中三分之一处放置pH探头。自主呼吸的患者中约66%出现GOR发作,而CMV患者中这一比例为92%(P < 0.01)。反流主要发生在拔除LMA后(21%对68%;P < 0.01)以及在麻醉后护理单元(PACU)(29%对43%;P < 0.05)。在使用LMA麻醉的小儿患者中,全身麻醉期间及在PACU中GOR的发生率较高。GOR发作在CMV组中明显更常见,主要发生在拔除LMA后,但无临床意义。

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