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仰卧位到俯卧位的体位改变会引起气管内导管套囊压力的改变,并伴有导管移位。

The supine-to-prone position change induces modification of endotracheal tube cuff pressure accompanied by tube displacement.

机构信息

Department of Anesthesiology, Wakayama Medical University, Wakayama 641-0012, Japan.

出版信息

J Clin Anesth. 2013 Feb;25(1):28-31. doi: 10.1016/j.jclinane.2012.05.007.

Abstract

STUDY OBJECTIVES

To determine whether the supine-to-prone position change displaced the endotracheal tube (ETT) and, if so, whether the displacement related to this change modified ETT cuff pressure.

DESIGN

Prospective study.

SETTING

Operating room of a university hospital.

PATIENTS

132 intubated, adult, ASA physical status 1, 2, and 3 patients undergoing lumbar spine surgery.

INTERVENTIONS AND MEASUREMENTS

After induction of anesthesia, each patient's trachea was intubated. The insertion depth of each ETT was 23 cm for men and 21 cm for women at the upper incisors. In the supine position and after the supine-to-prone position change with the head rotated to the right, the length from the carina to ETT tip and ETT cuff pressure were measured.

MAIN RESULTS

After the supine-to-prone position change, 91.7% patients had ETT tube displacement. Of these, 48% of patients' ETT moved ≥ 10 mm, whereas 86.3% of patients had changes in tube cuff pressure. There was a slight but significant correlation between ETT movement and change in cuff pressure. Depending on the position change, ETT cuff pressure decreased and the ETT tended to withdraw.

CONCLUSIONS

After the supine-to-prone position change, patients had ETT tube displacement. Such ETT movement may be accompanied by a decrease in cuff pressure.

摘要

研究目的

确定仰卧位到俯卧位的体位改变是否会导致气管内导管(ETT)移位,如果是,这种移位是否与 ETT 套囊压力的改变有关。

设计

前瞻性研究。

地点

一家大学医院的手术室。

患者

132 名接受腰椎手术的插管、成年、ASA 身体状况 1、2 和 3 级患者。

干预措施和测量

在全身麻醉诱导后,对每位患者的气管进行插管。每个 ETT 的插入深度为男性上切牙 23cm,女性上切牙 21cm。在仰卧位和头向右侧旋转的仰卧位到俯卧位改变后,测量隆突至 ETT 尖端的长度和 ETT 套囊压力。

主要结果

仰卧位到俯卧位改变后,91.7%的患者发生 ETT 管移位。其中,48%的患者 ETT 移动≥10mm,而 86.3%的患者 ETT 套囊压力发生变化。ETT 运动与套囊压力变化之间存在微弱但显著的相关性。根据体位改变,ETT 套囊压力降低,ETT 倾向于退缩。

结论

仰卧位到俯卧位改变后,患者发生 ETT 管移位。这种 ETT 运动可能伴有套囊压力降低。

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