Department of Anesthesia, Toronto Western Hospital, 399 Bathurst St., MC2-405, Toronto, ON, M5T 2S8, Canada.
Can J Anaesth. 2011 Jun;58(6):532-9. doi: 10.1007/s12630-011-9497-3. Epub 2011 Apr 5.
This study compared the Boussignac™ continuous positive airway pressure (CPAP) mask with the venturi face mask in terms of the postoperative PaO2/F(I)O2 (PF) ratio in morbidly obese patients after bariatric surgery.
Following hospital Research Ethics Board approval and written informed consent, morbidly obese (body mass index > 35 kg·m(-2)) patients undergoing bariatric surgery were recruited. The patients were anesthetized and laparoscopic Roux-en-Y gastric bypass was performed. Patients were assigned randomly to receive either the Boussignac (Boussignac Group) or the venturi face mask (Venturi Group) immediately after tracheal extubation. Patients were transported to the postanesthesia care unit, and the respective devices were applied for one hour. The PF ratio was recorded after tracheal intubation and at one hour and two hours post extubation. The percent forced expiratory volume (%FEV1) and the percent forced vital capacity (%FVC) were recorded preoperatively and at one hour and two hours post extubation. Independent Student's t tests were used for continuous variables, and the Chi square test was used for categorical variables. P < 0.05 was considered statistically significant.
Eighty-one patients (Group Boussignac, n = 43; Group Venturi, n = 38) completed the study. Mean ages and body mass indices were similar in the two groups. At one hour post extubation, the PF ratio in the Boussignac Group was 361 (170) compared with 279 (91) in the Venturi Group (P = 0.007), and at two hours post extubation, the PF ratio in the Boussignac Group was 371 (162) compared with 323 (127) in the Venturi Group (P = 0.1). The postoperative %FEV(1) and %FVC were comparable in both groups at all time points.
Compared with the venturi mask, the Boussignac CPAP mask improves the postoperative PF ratio in morbidly obese patients after bariatric surgery. The postoperative %FEV1 and %FVC are comparable for both groups.
本研究比较了肥胖患者行减重手术后，连续气道正压通气（CPAP）面罩（Boussignac 面罩）与文丘里面罩对术后 PaO2/F（I）O2（PF）比值的影响。
本研究经医院伦理审查委员会批准，并获得患者书面知情同意后，纳入病态肥胖（体重指数>35kg·m(-2)）患者。患者接受全身麻醉并完成腹腔镜下胃旁路术。术后患者随机接受 Boussignac 面罩（Boussignac 组）或文丘里面罩（文丘里组）通气。患者被转运至麻醉后恢复室，分别应用相应通气装置 1 小时。记录气管插管后、拔管后 1 小时和 2 小时的 PF 比值。记录术前、拔管后 1 小时和 2 小时的用力呼气量（FEV1）%和用力肺活量（FVC）%。采用独立样本 t 检验分析连续变量，采用卡方检验分析分类变量。P<0.05 为差异有统计学意义。
81 例患者（Boussignac 组 43 例，文丘里组 38 例）完成研究。两组患者的平均年龄和体重指数相似。拔管后 1 小时，Boussignac 组 PF 比值为 361（170），文丘里组为 279（91）（P=0.007），拔管后 2 小时，Boussignac 组 PF 比值为 371（162），文丘里组为 323（127）（P=0.1）。两组患者在各个时间点的术后 FEV1%和 FVC%均无显著差异。
与文丘里面罩相比，肥胖患者行减重手术后，Boussignac CPAP 面罩可改善术后 PF 比值。两组患者的术后 FEV1%和 FVC%无显著差异。
