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右美托咪定镇静下脊髓麻醉期间 STOP-Bang 评分与血氧饱和度的相关性

The correlation between the STOP-Bang score and oxygen saturation during spinal anesthesia with dexmedetomidine sedation.

作者信息

Yun Minsu, Kim Jiwook, Ryu Sungwon, Han Seo, Shin Yusom

机构信息

Department of Anesthesiology and Pain Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.

Department of Anesthesiology and Pain Medicine, Busan Central Hospital, Busan, Korea.

出版信息

Anesth Pain Med (Seoul). 2021 Jul;16(3):305-311. doi: 10.17085/apm.21011. Epub 2021 Jul 15.

Abstract

BACKGROUND

The STOP-Bang questionnaire is a simple screening tool with high sensitivity for the detection of severe obstructive sleep apnea. Predicting airway obstruction would allow the safe management of sedative patients to prevent intraoperative hypoxia. This study was designed to check the correlation between the STOP-Bang score and oxygen saturation (SpO2) during sedation and confirm the availability of the STOP-Bang questionnaire as a preoperative exam for predicting the incidence of hypoxia in sedative patient management.

METHODS

This study included 56 patients who received spinal anesthesia. The pre-anesthesia evaluation was conducted using the STOP-Bang questionnaire. The patients were under spinal anesthesia with an average block level of T10. Dexmedetomidine was infused with a loading dose of 1 μg/kg over 10 min and a maintenance dose of 0.5 μg/kg/h until the end of the procedure. The SpO2 of the patients was recorded every 5 min.

RESULTS

The STOP-Bang score was negatively correlated with the lowest SpO2 (coefficient = -0.774, 95% confidence interval [CI]: -0.855 to -0.649, standard error [SE] = 0.054, P < 0.001). The item of "observed apnea" was the most correlated one with hypoxic events (odds ratio = 6.00, 95% CI: 1.086 to 33.145).

CONCLUSIONS

The STOP-BANG score was significantly correlated with the lowest SpO2 during spinal anesthesia, which enabled the prediction of meaningful hypoxia before it occurred in the sedated patients.

摘要

背景

STOP - Bang问卷是一种简单的筛查工具,对检测重度阻塞性睡眠呼吸暂停具有高灵敏度。预测气道阻塞有助于安全管理接受镇静的患者,以预防术中缺氧。本研究旨在检查STOP - Bang评分与镇静期间血氧饱和度(SpO2)之间的相关性,并确认STOP - Bang问卷作为术前检查用于预测镇静患者管理中缺氧发生率的可用性。

方法

本研究纳入56例接受脊髓麻醉的患者。使用STOP - Bang问卷进行麻醉前评估。患者接受脊髓麻醉,平均阻滞平面为T10。静脉输注右美托咪定,负荷剂量为1μg/kg,持续10分钟,维持剂量为0.5μg/kg/h直至手术结束。每隔5分钟记录患者的SpO2。

结果

STOP - Bang评分与最低SpO2呈负相关(系数=-0.774,95%置信区间[CI]:-0.855至-0.649,标准误[SE]=0.054,P<0.001)。“观察到呼吸暂停”这一项目与缺氧事件相关性最强(比值比=6.00,95%CI:1.086至33.145)。

结论

STOP - Bang评分与脊髓麻醉期间的最低SpO2显著相关,这使得能够在镇静患者发生有意义的缺氧之前进行预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bae1/8342822/d48dfa19ac62/apm-21011f1.jpg

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