Kohro Shinji, Yamakage Michiaki, Takahashi Toshiyuki, Kondo Mitsu, Ota Koichi, Namiki Akiyoshi
Departments of Anesthesia Ebetsu Municipal Hospital Ebetsu, and the Sapporo Medical University, School of Medicine, Sapporo Hokkaido Japan.
Can J Anaesth. 2002 Feb;49(2):144-7. doi: 10.1007/BF03020486.
To investigate the interactions of a new lithotomy positioning device (LPD) with two intermittent pneumatic compression (IPC) devices by measuring femoral venous flow velocity.
Subjects were divided into three groups: 1) supine position as a control, 2) lithotomy position using a conventional LPD, and 3) lithotomy position using a new LPD, Levitator(TM). These three groups were further divided in two according to the type of IPC device used: AV-impulse(TM) (rapid IPC) and SeQuel(TM) (standard IPC). Peak femoral venous flow velocity was measured by using an ultrasonic echo diagnostic device. Data were analyzed by one-way ANOVA with Fisher's test or by the unpaired two-tailed t test.
Moving to the conventional lithotomy position from the supine position, venous flow velocity was decreased by 38% in both IPC device groups. Even when the new LPD was used to support the lithotomy position, the flow velocity was decreased by 24%, but the velocity was significantly higher than in the conventional lithotomy position. Both rapid and standard IPC devices increased flow velocity to 77% and 107% (first compression) and to 71% and 84% (fifth compression) of the control values during compression, respectively. In the lithotomy position group using the new LPD, similar increases in flow were seen with the use of IPC devices.
Both rapid and standard IPC devices are useful for maintaining venous flow of the lower extremities in the lithotomy position.
通过测量股静脉血流速度,研究一种新型截石位定位装置(LPD)与两种间歇性气动压迫(IPC)装置之间的相互作用。
将受试者分为三组:1)仰卧位作为对照组;2)使用传统LPD的截石位;3)使用新型LPD(Levitator™)的截石位。根据所使用的IPC装置类型,这三组又进一步分为两组:AV-impulse™(快速IPC)和SeQuel™(标准IPC)。使用超声回波诊断装置测量股静脉血流峰值速度。数据采用单因素方差分析和Fisher检验或非配对双尾t检验进行分析。
从仰卧位转变为传统截石位时,两个IPC装置组的静脉血流速度均降低了38%。即使使用新型LPD来支撑截石位,血流速度仍降低了24%,但该速度显著高于传统截石位时的速度。在压迫过程中,快速和标准IPC装置分别将血流速度提高到对照组值的77%和107%(第一次压迫)以及71%和84%(第五次压迫)。在使用新型LPD的截石位组中,使用IPC装置时也观察到类似的血流增加情况。
快速和标准IPC装置均有助于在截石位时维持下肢静脉血流。