Zhang Shaojin, Nie Jiying, Tu Wencai, Zhong Changgen, Liu Qing, Li Jianhua
Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China.
Am J Transl Res. 2021 Jul 15;13(7):8165-8171. eCollection 2021.
This study aimed to investigate the effect of supraglottic ventilation via transtracheal catheter in painless endoscopic retrograde cholangiopancreatography (ERCP).
Sixty patients with painless ERCP who were treated in our hospital were enrolled as the study subjects and divided into a study group (n=30) and a control group (n=30) according to the method of ventilation during the operation. The control group received ventilation via modified laryngeal mask, while the study group received supraglottic ventilation through a transtracheal tube. The mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO), and End-tidal CO (EtCO) at multiple time points after admission (T0), after induction of anesthesia (T1), immediately after catheter placement (T2), immediately after operation (T3), and at the time of resuscitation (T4) were compared between the two groups. The incidence of various adverse events in the perioperative period was also compared.
The two groups showed significant fluctuations in intraoperative hemodynamic parameters. However, the changes in MAP, SpO and ETCO of the study group were more stable, and better than those of the control group at the T2 and T3 (<0.05). The intubation time, operation time and recovery time of patients in the study group were significantly lower than those in the control group (<0.05). The total incidence of adverse events in the study group was significantly lower than that in the control group (<0.05).
It is highly feasible to apply supraglottic ventilation with transvalvular catheter in painless ERCP, which can significantly stabilize the perioperative hemodynamic parameters, accelerate recovery and also help decrease the rate of postoperative complications.
本研究旨在探讨经气管导管声门上通气在无痛内镜逆行胰胆管造影术（ERCP）中的效果。
选取在我院接受无痛ERCP治疗的60例患者作为研究对象，根据手术期间的通气方法分为研究组（n = 30）和对照组（n = 30）。对照组通过改良喉罩通气，而研究组通过经气管导管进行声门上通气。比较两组患者入院后（T0）、麻醉诱导后（T1）、导管置入后即刻（T2）、手术结束后即刻（T3）和复苏时（T4）多个时间点的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO）和呼气末二氧化碳分压（EtCO）。同时比较围手术期各种不良事件的发生率。
两组患者术中血流动力学参数均有明显波动。然而，研究组在T2和T3时MAP、SpO和EtCO的变化更稳定，且优于对照组（<0.05）。研究组患者的插管时间、手术时间和恢复时间均显著低于对照组（<0.05）。研究组不良事件的总发生率显著低于对照组（<0.05）。
在无痛ERCP中应用经气管导管声门上通气具有高度可行性，可显著稳定围手术期血流动力学参数，加速恢复，并有助于降低术后并发症发生率。
