Sarasota, Fla.; Freehold, N.J.; Dublin, Ireland; and Cleveland, Ohio From the Sarasota Plastic Surgery Center; New Reflections Plastic Surgery; St. Vincent's University Hospital; and the Departments of Plastic Surgery and General Anesthesia and Quantitative Health Sciences, Cleveland Clinic.
Plast Reconstr Surg. 2012 Sep;130(3):681-689. doi: 10.1097/PRS.0b013e31825dc14a.
The second part of the authors' study on operating room fires analyzes the construct of the nasal cannula used during facial surgery for patients under conscious sedation with supplemental oxygen. This prospective study compares two common styles of nasal cannulas with a nasopharyngeal system described in their first report.
Twenty patients underwent upper and/or lower lid blepharoplasty under conscious sedation with one of three methods of supplemental oxygen delivery: a Mac-Safe nasal cannula (Unomedical, Inc., McAllen, Texas), a Salter nasal cannula (Salter Laboratories, Arvin, Calif.), and a nasopharyngeal system with cut ends of a cannula placed into a rubber nasopharyngeal tube. Oxygen concentrations were measured at 24 locations around the face for each method at a low (3 liters/minute) and high flow rates (6 liters/minute) using a random access mass spectrometer unit.
At both low and high oxygen flow rates, the median oxygen concentration at and above the nose was statistically lower (p < 0.001) using the nasopharyngeal system than with either the Mac-Safe or Salter nasal cannula. In addition, the oxygen concentrations measured using the two nasal cannulas were more variable than with the nasopharyngeal method, particularly at locations around and above the nose.
This study demonstrates that mass spectrometry oxygen readings around the face are similar to room air when the cut ends of the oxygen cannulas are passed down the nasaopharyngeal tube, whereas readings are significantly higher with the nasal cannulas. The nasopharyngeal system that the authors describe represents a significantly safer means of oxygen delivery during conscious sedation.
作者关于手术室火灾的研究的第二部分分析了在接受补充氧气的镇静患者面部手术中使用的鼻管的结构。这项前瞻性研究比较了三种补充氧气输送方法中的两种常见鼻管与他们的第一份报告中描述的鼻咽系统。
二十名患者在接受镇静下接受了上睑和/或下睑眼睑成形术，使用以下三种补充氧气输送方法中的一种：Mac-Safe 鼻管（Unomedical，Inc.，McAllen，Texas），Salter 鼻管（Salter Laboratories，Arvin，加利福尼亚州）和鼻咽系统，将管的切断端放置在橡胶鼻咽管中。使用随机存取质谱单元，以低（3 升/分钟）和高流速（6 升/分钟）测量每种方法在面部周围 24 个位置的氧气浓度。
在低和高氧气流速下，使用鼻咽系统时，鼻子上方和上方的中位数氧气浓度均明显低于（p <0.001），与 Mac-Safe 或 Salter 鼻管相比。此外，与鼻咽方法相比，使用两种鼻管测量的氧气浓度变化更大，尤其是在鼻子周围和上方的位置。
这项研究表明，当氧气管的切断端通过鼻咽管向下传递时，面部周围的质谱氧读数与室温空气相似，而使用鼻管时读数则明显更高。作者描述的鼻咽系统代表了在清醒镇静期间更安全的氧气输送方式。
