Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
J Clin Anesth. 2013 Mar;25(2):106-9. doi: 10.1016/j.jclinane.2012.06.025. Epub 2013 Jan 25.
To characterize respiratory dynamics during emergence from propofol-remifentanil anesthesia using noninvasive respiratory inductance plethysmography (RIP).
Observational pilot study.
Operating room in a university-affiliated teaching hospital.
50 ASA physical status 1, 2, and 3 patients scheduled for microdirect laryngoscopy or bronchoscopy using total intravenous anesthesia (TIVA) with high-frequency jet ventilation.
Patients were fitted with plethysmography bands around the chest and abdomen prior to induction. Following completion of surgery in patients undergoing brief airway procedures using propofol-remifentanil general anesthesia, the anesthetic infusions were stopped and ventilation suspended until resumption of spontaneous ventilation or desaturation below 90%. During this period of apnea, abdominal and thoracic girth was assessed with noninvasive RIP.
Cross-sectional area of the thorax and abdomen during emergence were measured.
Useful data were obtained from 41 patients, with stable apnea lasting 404 ± 193.1 seconds; of these, 34 exhibited a slow and significant decrease in abdominal girth over a period of 267.8 ± 128.5 seconds. Resumption of spontaneous ventilation generally coincided with the end of this abdominal relaxation.
Slow expiration is the initial step in the resumption of spontaneous ventilation during apnea induced with TIVA using propofol-remifentanil.
使用非侵入性呼吸感应体容积描记法（RIP）描述异丙酚-瑞芬太尼麻醉苏醒期间的呼吸动力学。
观察性试点研究。
大学附属医院的手术室。
50 名 ASA 身体状况 1、2 和 3 级患者，计划接受全身麻醉下的高频喷射通气（TIVA）进行微创喉镜或支气管镜检查。
在诱导前，患者胸部和腹部佩戴体容积描记带。对于使用异丙酚-瑞芬太尼全身麻醉进行短暂气道手术的患者，在完成手术后停止麻醉输注，并暂停通气，直到恢复自主通气或饱和度降至 90%以下。在此期间，使用非侵入性 RIP 评估腹部和胸廓的周长。
测量苏醒期间胸廓和腹部的横截面积。
41 名患者获得了有用的数据，稳定的呼吸暂停持续时间为 404±193.1 秒；其中 34 名患者在 267.8±128.5 秒内腹部周长缓慢而显著减小。自主通气的恢复通常与腹部松弛的结束同时发生。
在使用异丙酚-瑞芬太尼进行 TIVA 诱导的呼吸暂停期间，自主通气恢复的初始步骤是缓慢呼气。
