压力控制通气与容量控制通气在腹腔镜胆囊切除术中的比较。
A comparison of pressure-controlled and volume-controlled ventilation for laparoscopic cholecystectomy.
机构信息
Department of Anaesthesiology & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Shahadra, Delhi, India.
出版信息
Anaesthesia. 2011 Jun;66(6):503-8. doi: 10.1111/j.1365-2044.2011.06713.x. Epub 2011 Apr 18.
The potential advantages of pressure-controlled over volume-controlled ventilation during laparoscopic surgery have yet to be proven. We randomly assigned 42 patients with BMI <30 kg.m(-2) scheduled for laparoscopic cholecystectomy to receive either pressure- or volume-controlled ventilation. Compared with volume-controlled ventilation, pressure-controlled ventilation resulted in a significant decrease in mean (SD) peak airway pressure at 10 min (20.4 (2.7) vs 24.0 (4.7)cmH₂O, p=0.004) and 30 min (20.7 (3.0) vs 23.9 (4.9)cmH₂O, p=0.015) and an increase in mean airway pressure at 10 min (10.5 (0.9) vs 9.6 (1.1)cmH₂O, p=0.007) and 30 min (10.5 (1.1) vs 9.6 (1.2)cmH₂O, p=0.016) after the start of surgery. Gas exchange and haemodynamic stability were similar. We conclude that pressure-controlled ventilation is a safe alternative and offers some advantages to volume-controlled ventilation during laparoscopic cholecystectomy in non-obese patients.
在腹腔镜手术中，压力控制通气相对于容量控制通气具有潜在的优势，但尚未得到证实。我们将 42 例 BMI<30kg·m(-2)拟行腹腔镜胆囊切除术的患者随机分为压力控制通气组或容量控制通气组。与容量控制通气相比，压力控制通气在 10 分钟（20.4(2.7)cmH₂O 比 24.0(4.7)cmH₂O，p=0.004）和 30 分钟（20.7(3.0)cmH₂O 比 23.9(4.9)cmH₂O，p=0.015）时的平均（标准差）气道峰压显著降低，并且在手术开始后 10 分钟（10.5(0.9)cmH₂O 比 9.6(1.1)cmH₂O，p=0.007）和 30 分钟（10.5(1.1)cmH₂O 比 9.6(1.2)cmH₂O，p=0.016）时的平均气道压升高。气体交换和血流动力学稳定性相似。我们的结论是，在非肥胖患者中，压力控制通气是一种安全的替代方法，并且在腹腔镜胆囊切除术中相对于容量控制通气具有一些优势。
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