Stalford Catherine B
Virginia Commonwealth University, Richmond, Va., USA.
AANA J. 2004 Apr;72(2):133-8.
Recent epidemiological research places the incidence of obstructive sleep apnea as high as 16% in the general population. Serious postoperative respiratory complications and death have been reported in this population. Anesthetic drugs contribute to these complications secondary to acute and residual influences on the complex orchestration of airway muscles and reflexes involved in airway patency. The Starling resistor model is a theoretical model that has application in explaining upper airway dynamics and the treatment and management of obstructive sleep apnea. The model postulates the oropharynx as a collapsible tube. The oropharynx remains open or partially or completely closed as a result of pressure upstream at the nose and mouth, pressure downstream at the trachea and below, or tissue pressure surrounding the oropharynx. This AANA Journal course provides an overview of the Starling resistor model, its application to obstructive sleep apnea, and preoperative and postoperative anesthetic considerations.
近期的流行病学研究表明，普通人群中阻塞性睡眠呼吸暂停的发病率高达16%。据报道，这一人群术后会出现严重的呼吸并发症甚至死亡。麻醉药物会对维持气道通畅的气道肌肉和反射的复杂协调产生急性和残留影响，从而导致这些并发症。斯塔林电阻器模型是一个理论模型，可用于解释上气道动力学以及阻塞性睡眠呼吸暂停的治疗和管理。该模型假定口咽为可塌陷的管道。由于口鼻处的上游压力、气管及以下部位的下游压力或口咽周围的组织压力，口咽会保持开放状态，或部分或完全关闭。本《美国麻醉护士协会杂志》课程概述了斯塔林电阻器模型、其在阻塞性睡眠呼吸暂停中的应用以及术前和术后的麻醉注意事项。
