Matsunami Sayuri, Komasawa Nobuyasu, Konishi Yuki, Minami Toshiaki
Department of Anesthesiology, Osaka Medical College, Osaka, Japan.
Department of Anesthesiology, Osaka Medical College, Osaka, Japan.
Am J Emerg Med. 2017 Nov;35(11):1709-1712. doi: 10.1016/j.ajem.2017.05.004. Epub 2017 May 8.
We performed two prospective randomized crossover trials to evaluate the effect of head elevation or lateral head rotation to facemask ventilation volume.
In the first trial, facemask ventilation was performed with a 12-cm high pillow (HP) and 4-cm low pillow (LP) in 20 female patients who were scheduled to undergo general anesthesia. In the second trial, facemask ventilation was performed with and without lateral head rotation in another 20 female patients. Ventilation volume was measured in a pressure-controlled ventilation (PCV) manner at 10, 15, and 20 cmHO inspiratory pressures.
In the first trial evaluating head elevation effect, facemask ventilation volume was significantly higher with a HP than with a LP at 15 and 20 cmHO inspiratory pressure (15 cmHO: HP 540 [480-605] mL, LP 460 [400-520] mL, P=0.006, 20 cmHO: HP 705 [650-800] mL, LP 560 [520-677] mL, P<0.001). In the second trial, lateral head rotation did not significantly increase facemask ventilation volume at all inspiratory pressure.
Head elevation increased facemask ventilation volume in normal airway patients, while lateral head rotation did not.
我们进行了两项前瞻性随机交叉试验，以评估头部抬高或头部向面罩侧旋转对通气量的影响。
在第一项试验中，对20例计划接受全身麻醉的女性患者使用12厘米高的枕头（HP）和4厘米低的枕头（LP）进行面罩通气。在第二项试验中，对另外20例女性患者分别在头部不旋转和向面罩侧旋转的情况下进行面罩通气。在吸气压力为10、15和20厘米水柱时，以压力控制通气（PCV）方式测量通气量。
在第一项评估头部抬高效果的试验中，在吸气压力为15和20厘米水柱时，使用HP时的面罩通气量显著高于使用LP时（15厘米水柱：HP为540[480 - 605]毫升，LP为460[400 - 520]毫升，P = 0.006；20厘米水柱：HP为705[650 - 800]毫升，LP为560[520 - 677]毫升，P < 0.001）。在第二项试验中，在所有吸气压力下，头部向面罩侧旋转均未显著增加面罩通气量。
对于气道正常的患者，头部抬高可增加面罩通气量，而头部向面罩侧旋转则不能。
