Cillo Joseph E, Finn Richard
Oral and Maxillofacial Surgery, Parkland Memorial Hospital, The University of Texas Southwestern Medical Center, Dallas, USA.
J Oral Maxillofac Surg. 2005 Jun;63(6):752-5. doi: 10.1016/j.joms.2005.02.004.
Patients undergoing office-based laser-assisted uvuloplasty (LAUP) for snoring or mild obstructive sleep apnea are generally obese and have a high Mallampati score. Because avoidance of supplemental oxygen during laser procedures is generally mandated, the potential for intraoperative desaturation is high. This study was designed to look at intraoperative hemodynamic changes, respiration patterns, and oxygen saturations during intravenous sedation with midazolam and fentanyl during LAUP procedures.
This was a retrospective anesthesia chart review of 15 consecutive patients undergoing midazolam/fentanyl intravenous sedation for office-based LAUP treatment for snoring and/or mild obstructive sleep apnea. Data recorded were noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse (P), and rate-pressure product (RPP). Data collected were reported as mean values with standard deviation. Statistical analysis using the Student's t test was performed and found significant for P<.05.
All changes from baseline were statistically insignificant, SBP (P=.4), DBP (P=.2), MAP (P=.2), P (P=.1), PP (P=.9), RPP (P=.5), RR (P=.9), and SpO2 (P=.4), and all within +/-20% of baseline (range, -5.0% to +7.5%).
Midazolam and fentanyl intravenous sedation with local anesthesia maintained intraoperative hemodynamic and oxygenation variables close to baseline for office-based LAUP procedures.
接受门诊激光辅助悬雍垂成形术(LAUP)治疗打鼾或轻度阻塞性睡眠呼吸暂停的患者通常肥胖且马兰帕蒂评分较高。由于激光手术期间通常要求避免使用补充氧气,术中发生低氧饱和度的可能性很高。本研究旨在观察LAUP手术期间静脉注射咪达唑仑和芬太尼进行镇静时的术中血流动力学变化、呼吸模式和氧饱和度。
这是一项对15例连续接受咪达唑仑/芬太尼静脉镇静以进行门诊LAUP治疗打鼾和/或轻度阻塞性睡眠呼吸暂停的患者的麻醉图表回顾性研究。记录的数据为无创基线值以及术中每隔5分钟测量的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、脉压(PP)、脉搏(P)和速率-压力乘积(RPP)的血流动力学指标。收集的数据以平均值±标准差报告。使用学生t检验进行统计分析,P<0.05时具有统计学意义。
与基线相比的所有变化均无统计学意义,SBP(P = 0.4)、DBP(P = 0.2)、MAP(P = 0.2)、P(P = 0.1)、PP(P = 0.9)、RPP(P = 0.5)、RR(P = 0.9)和SpO2(P = 0.4),且均在基线值的±20%范围内(范围为-5.0%至+7.5%)。
咪达唑仑和芬太尼静脉镇静联合局部麻醉可使门诊LAUP手术的术中血流动力学和氧合变量维持在接近基线水平。