Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehakno, Jongnogu, Seoul, 03080, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea.
BMC Anesthesiol. 2022 Aug 15;22(1):257. doi: 10.1186/s12871-022-01803-5.
The use of cricoid compression to prevent insufflation remains controversial, and its use in children is limited. This study aimed to examine the effect of real-time ultrasound-guided esophageal compression on the prevention of gastric insufflation.
This prospective observational study was conducted with fifty children aged < 2 years undergoing general anesthesia. Patients were excluded if they were at an increased risk for gastric regurgitation or pulmonary aspiration. Following anesthetic induction under spontaneous breathing, ultrasound-guided esophageal compression was performed during pressure-controlled face-mask ventilation using a gradual increase in peak inspiratory pressure from 10 to 24 cm HO to determine the pressure at which gastric insufflation occurred. The primary outcome was the incidence of gastric insufflation during anesthetic induction with variable peak inspiratory pressure after real-time ultrasound-guided esophageal compression was applied.
Data from a total of 42 patients were analyzed. Gastric insufflation was observed in 2 (4.7%) patients. All patients except one had their esophagus on the left side of the trachea. Applying ultrasound-guided esophageal compression did not affect the percentage of glottic opening scores (P = 0.220).
The use of real-time ultrasound-guided esophageal compression pressure can aid preventing gastric insufflation during face-mask ventilation in children less than 2 years old.
Clinicaltrials.gov identifier: NCT04645043.
环甲膜压迫预防注气仍存在争议，其在儿童中的应用受到限制。本研究旨在研究实时超声引导食管压迫对预防胃充气的效果。
本前瞻性观察研究纳入了 50 名年龄<2 岁的行全身麻醉的儿童。如果患者存在胃反流或肺吸入的风险增加，则将其排除在外。在自主呼吸下进行麻醉诱导后，使用压力控制面罩通气，逐渐增加峰吸气压从 10 增加到 24cmH2O，以确定发生胃充气时的压力。主要结局是在实时超声引导食管压迫后应用不同的峰吸气压进行麻醉诱导期间胃充气的发生率。
共分析了 42 名患者的数据。2 名（4.7%）患者出现胃充气。除 1 名患者外，所有患者的食管均位于气管左侧。应用超声引导食管压迫对声门开放评分的百分比没有影响（P=0.220）。
在<2 岁的儿童中，使用实时超声引导食管压迫压力可有助于预防面罩通气时的胃充气。
Clinicaltrials.gov 标识符：NCT04645043。
