Kung Theodore A, Kong Sarah W, Aliu Oluseyi, Azizi Jahan, Kai Salim, Cederna Paul S
Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
J Clin Anesth. 2016 Feb;28:56-61. doi: 10.1016/j.jclinane.2015.08.006. Epub 2015 Oct 1.
To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting.
Experimental.
Clinical simulation center of a university-affiliated hospital.
Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula.
Vacuum suctioning and strategic drape tenting.
The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%.
In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P < .01) or in combination with strategic tenting (110 seconds; P < .01) significantly reduced this time. No significant benefit was seen when tenting was used alone (160 seconds; P < .30).
Use of a vacuum suction device during surgery will lower local oxygen concentration, and this in turn may decrease the risk of operating room fires. Although strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended.
在实验环境中研究真空抽吸和策略性手术单帐篷效应单独及联合作用对氧浓度的影响。
实验性研究。
大学附属医院临床模拟中心。
模拟接受镇静麻醉下面部手术的患者模型。通过鼻导管输送补充氧气。
真空抽吸和策略性手术单帐篷效应。
实验性试验包括在有或无标准手术室真空抽吸系统及手术单策略性帐篷效应的情况下，持续测量鼻导管周围的氧浓度。主要结局指标为氧浓度达到21%所需的时间。
在对照组（无抽吸或策略性帐篷效应）中，停止输氧后，测得的氧浓度达到21%平均需要180秒。单独使用真空抽吸装置（110秒；P < 0.01）或与策略性帐篷效应联合使用（110秒；P < 0.01）均显著缩短了该时间。单独使用帐篷效应（160秒；P < 0.30）未观察到显著益处。
手术期间使用真空抽吸装置会降低局部氧浓度，进而可能降低手术室火灾风险。尽管手术单策略性帐篷效应在理论上有利于减少手术部位周围的氧气积聚，但在推荐常规使用之前还需要进一步研究。
