Hooda Sarla, Kaur Kiranpreet, Rattan Kamal N, Thakur Anil K, Kamal Kirti
Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak, India.
J Anaesthesiol Clin Pharmacol. 2012 Jan;28(1):28-31. doi: 10.4103/0970-9185.92430.
Clinical tests, such as loss of verbal contact, eyelash reflex, corneal reflex, and jaw relaxation, are used to assess the depth of anesthesia. "Trapezius squeeze test" (TST) is one such clinical test. It is a simple test to perform in which 1-2 inches of trapezius muscle is held and squeezed in full thickness and response is evaluated in the form of toe/body movement.
One hundred pediatric patients between 3 and 5 years of age, scheduled to undergo elective surgery, were included in this study. We evaluated negative TST as an indicator for optimal anesthesia depth for laryngeal mask airway (LMA) insertion in anesthetized spontaneously breathing children. Anesthesia was induced using 4% sevoflurane in oxygen. As the child lost the verbal contact or loss of body movement, TST was performed. Test was repeated every 15 s till it became negative. When the TST became negative, a well lubricated, appropriate-size LMA was inserted.
Mean time for TST to become negative in our study was 271.80 ± 55.8 s and ease of insertion was excellent in 91 patients and acceptable in 9 patients. LMA was successfully inserted in first attempt in 96% patients.
Negative TST is a reliable indicator for placement of LMA in spontaneously breathing children. Excellent conditions for LMA placement are present in majority of the patients without any untoward effects at this point of time.
诸如言语交流丧失、睫毛反射、角膜反射及下颌松弛等临床测试被用于评估麻醉深度。“斜方肌挤压试验”（TST）就是这样一种临床测试。它是一项操作简单的测试，即对1 - 2英寸厚的斜方肌进行全层挤压，并以脚趾/身体运动的形式评估反应。
本研究纳入了100例年龄在3至5岁、计划接受择期手术的儿科患者。我们将阴性TST评估为在麻醉下自主呼吸儿童中插入喉罩气道（LMA）时最佳麻醉深度的指标。采用4%七氟醚吸入氧诱导麻醉。当患儿出现言语交流丧失或身体运动消失时，进行TST测试。每15秒重复测试一次，直至测试结果为阴性。当TST结果为阴性时，插入充分润滑且尺寸合适的LMA。
在我们的研究中，TST变为阴性的平均时间为271.80 ± 55.8秒，91例患者LMA插入顺利，9例患者可接受。96%的患者首次尝试LMA插入成功。
阴性TST是自主呼吸儿童中放置LMA的可靠指标。大多数患者此时具备LMA放置的良好条件，且无任何不良影响。
