Koga Tomomichi, Kawamoto Masashi
Division of Clinical Medical Science, Department of Anesthesiology and Critical Care, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Chugoku Rosai General Hospital, Kure 737-0193, Japan.
J Clin Anesth. 2009 May;21(3):178-82. doi: 10.1016/j.jclinane.2008.06.037.
To investigate whether gender difference has an effect on an anesthesia resident's ability to perform successful mask ventilation.
Cohort study.
Surgical operation theater of a university-affiliated hospital.
839 ASA physical status I, II, and III patients undergoing general anesthesia performed by residents.
Mask ventilation was performed by 21 different anesthesia residents.
Difficult mask ventilation was defined as the inability of an unassisted resident to maintain oxygen saturation, significant gas flow leakage beneath the face mask, need to increase gas flow, no perceptible chest movement, assistance required using a two-handed mask ventilation technique, or use of the oxygen flush valve more than twice.
Instances of difficult mask ventilation were observed in 210 patients (25.0%), though all were adequately ventilated with a face mask. Difficult mask ventilation was observed significantly more often with female (29.8%) than male (20.0%) residents. Residents' gender was shown to be an independent risk factor for difficult mask ventilation.
Gender difference has an effect on the mask ventilation learning process, as it was more difficult for female residents to provide a tight air seal in the early stage of training.
探讨性别差异是否会影响麻醉住院医师成功进行面罩通气的能力。
队列研究。
一所大学附属医院的外科手术室。
839例接受住院医师实施全身麻醉的美国麻醉医师协会(ASA)身体状况分级为I、II和III级的患者。
由21名不同的麻醉住院医师进行面罩通气。
困难面罩通气定义为住院医师在无辅助情况下无法维持氧饱和度、面罩下有明显气体泄漏、需要增加气体流量、无明显胸部运动、需要使用双手面罩通气技术辅助或使用氧气快速充气阀超过两次。
210例患者(25.0%)出现困难面罩通气情况,不过所有患者均通过面罩实现了充分通气。女性住院医师(29.8%)出现困难面罩通气的情况明显多于男性住院医师(20.0%)。住院医师的性别是困难面罩通气的独立危险因素。
性别差异对面罩通气学习过程有影响,因为女性住院医师在训练初期更难实现紧密的气密封闭。