Dhar Rohini, Sofi Khalid, Mir Shafat Ahmad, Jehangir Majid, Wazir Mohsin
Department of Anesthesiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Anesth Essays Res. 2021 Jul-Sep;15(3):321-326. doi: 10.4103/aer.aer_120_21. Epub 2022 Feb 14.
Pediatric infraumbilical surgeries are often performed under general anaesthesia using different modes of ventilation through Laryngeal Mask Airway .Although controlled ventilation has been successfully used, very less studies have been done to compare them with spontaneous ventilation for short duration surgeries.
We tried to measure quantitave differences in haemodynamic and respiratory parameters and assess the recovery profile between controlled and spontaneous ventilation using Proseal LMA.
This was a prospective, randomized, double-blind study that comprised 90 American Society of Anaesthesiologist (ASA) classes I and II pediatric patients posted for infra umbilical surgery.
90 paediatric patients undergoing infraumbilical surgeries were included. Three different ventilation strategies: spontaneous , pressure support and pressure-controlled ventilation were applied depending on attending anaesthesiologist's preference. Haemodynamic and respiratory parameters were recorded during the procedure. Post procedure parameters including need for supplementary oxygen, recovery time, complications were recorded.
Analysis of variance (ANOVA) was employed for inter group analysis and for multiple comparisons, least significant difference (LSD) test was applied. Chi-square test or Fisher's exact test, whichever appropriate, was used for comparison of categorical variables.
The mean time interval between end of surgery and removal of LMA was significantly higher in PCV group in comparison to SV and PSV groups. In SV group lesser number of patients required oxygen supplementation and had shorter stay in recovery than PCV group.
We conclude that spontaneous mode of ventilation can be used as safely as controlled /assist ventilation mode in short duration surgeries in high turn over settings.
小儿脐下手术通常在全身麻醉下通过喉罩气道采用不同的通气模式进行。尽管控制通气已成功应用，但针对短时长手术将其与自主通气进行比较的研究却非常少。
我们试图测量血流动力学和呼吸参数的定量差异，并使用双管喉罩评估控制通气和自主通气之间的恢复情况。
这是一项前瞻性、随机、双盲研究，纳入了90例拟行脐下手术的美国麻醉医师协会（ASA）I级和II级小儿患者。
纳入90例接受脐下手术的小儿患者。根据麻醉医师的偏好应用三种不同的通气策略：自主通气、压力支持通气和压力控制通气。术中记录血流动力学和呼吸参数。记录术后参数，包括补充氧气的需求、恢复时间、并发症。
采用方差分析（ANOVA）进行组间分析和多重比较，应用最小显著差（LSD）检验。采用卡方检验或Fisher精确检验（视情况而定）比较分类变量。
与自主通气组和压力支持通气组相比，压力控制通气组手术结束至拔除喉罩的平均时间间隔显著更长。自主通气组需要补充氧气的患者数量较少，且在恢复室的停留时间比压力控制通气组短。
我们得出结论，在高周转率环境下的短时长手术中，自主通气模式与控制/辅助通气模式一样安全。
