Suppr超能文献

[全身麻醉下改良鼻咽通气道用于宫腔镜日间手术患者自主呼吸对术后恢复质量的影响]

[The effect of modified nasopharynx airway with spontaneous breathing under general anesthesia on the postoperative recovery quality of patients undergoing hysteroscopic daytime surgery].

作者信息

Wang H J, Chen H Y, Wang S S, Du Y J, Wang G Y

机构信息

Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Aug 8;103(29):2252-2257. doi: 10.3760/cma.j.cn112137-20230418-00625.

Abstract

To explore the impact of a new type of modified nasopharynx airway preserving spontaneous breathing under general anesthesia on the postoperative recovery quality of patients undergoing hysteroscopic daytime surgery. A total of 80 patients undergoing hysteroscopic daytime surgery at Beijing Tongren Hospital from August to December 2022 was prospectively selected. The patients were randomly divided into two groups using a random number table method: patients in the laryngeal mask mechanical ventilation general anesthesia group (laryngeal mask group, =40) aged (46.8±10.1) years (20-65 years), while patients in the modified nasopharyngeal airway preserving spontaneous breathing general anesthesia group (nasopharyngeal airway group, =40) aged (45.5±12.1) years (26-65 years). The main outcome measures were the clinical recovery score (CRS) and modified alertness and sedation score (MOAA/S) of patients at different postoperative time points. Secondary observation indicators included anesthesia induction time, awakening time, and extubation time, changes of hemodynamic indicators between preoperative and intraoperative period, and incidence of adverse reactions during and after surgery. The CRS scores [ (, )] of patients in the nasopharyngeal airway group were 8 (8, 9), 8 (8, 9), 8 (8, 9), 9 (9, 9) and 10 (10, 11) at postoperative awakening, immediately after extubation, 5 minutes after extubation, 15 minutes after extubation, and 30 minutes after extubation, respectively, which were higher than those in the laryngeal mask group [7 (6, 8), 7 (7, 8), 7 (7, 8), 8 (8, 8) and 9 (8, 9)] (all <0.001). The MOAA/S scores of the nasopharyngeal airway group were 5 (5, 5), 5 (5, 5), 5 (5, 5) and 5 (5, 5) at postoperative awakening, immediately after extubation, 5 minutes after extubation, and 15 minutes after extubation, respectively, which were higher than those in the laryngeal mask group [4 (3, 5), 4 (4, 5), 5 (5, 5) and 5 (5, 5)] (all <0.05). The anesthesia induction time, awakening time, and extubation time of the nasopharyngeal airway group were (47.8±4.3) s, (4.1±1.7) min and (4.5±1.7) min, respectively, which were shorter than those of laryngeal mask group [(138.8±4.2) s, (7.2±2.9) min and (8.1±2.7) min] (all <0.05). The mean arterial pressure (MAP) of patients in the nasopharynx airway group during extubation was (84.9±10.2) mmHg (1 mmHg=0.133 kPa), which was lower than that of the laryngeal mask group [(93.2±7.5) mmHg] (<0.05). The partial pressure of end-tidal carbon dioxide (PetCO) during cervical dilation was (22.0±5.9) mmHg, which was lower than those of the laryngeal mask group [(37.2±2.2) mmHg] (<0.05). The PetCO during intrauterine operation and extubation were (45.5±6.7) and (41.6±4.5) mmHg, which were higher than those of the laryngeal mask group [(39.2±4.1) mmHg and (38.6±3.6) mmHg] (both <0.05). The incidence of respiratory depression and body movement during surgery in the nasopharyngeal airway group were 27.5% (11/40) and 17.5% (7/40), respectively, which were higher than those in the laryngeal mask group [0 and 0] (both <0.05). The incidence of postoperative drowsiness was 2.5% (1/40), which was lower than that of the laryngeal mask group [17.5% (7/40)] (<0.05). There was no severe physical activity or intraoperative awareness in the two groups. The new modified general anesthesia method of preserving spontaneous breathing through the nasopharynx airway can improve the postoperative recovery quality of patients, and reduce the occurrence of adverse reactions, which facilitates rapid recovery after hysteroscopic daytime surgery.

摘要

探讨新型改良鼻咽通气道在全身麻醉下保留自主呼吸对宫腔镜日间手术患者术后恢复质量的影响。前瞻性选取2022年8月至12月在北京同仁医院行宫腔镜日间手术的80例患者。采用随机数字表法将患者随机分为两组:喉罩机械通气全身麻醉组(喉罩组,n = 40),年龄(46.8±10.1)岁(20 - 65岁);改良鼻咽通气道保留自主呼吸全身麻醉组(鼻咽通气道组,n = 40),年龄(45.5±12.1)岁(26 - 65岁)。主要观察指标为患者术后不同时间点的临床恢复评分(CRS)和改良警觉与镇静评分(MOAA/S)。次要观察指标包括麻醉诱导时间、苏醒时间、拔管时间,术前与术中血流动力学指标变化,以及手术中和术后不良反应发生率。鼻咽通气道组患者术后苏醒时、拔管即刻、拔管后5分钟、拔管后15分钟及拔管后30分钟的CRS评分[(中位数,四分位数间距)]分别为8(8,9)、8(8,9)、8(8,9)、9(9,9)和10(10,11),均高于喉罩组[7(6,8)、7(7,8)、7(7,8)、8(8,8)和9(8,9)](均P < 0.001)。鼻咽通气道组患者术后苏醒时、拔管即刻、拔管后5分钟及拔管后15分钟的MOAA/S评分分别为5(5,5)、5(5,5)、5(5,5)和5(5,5),均高于喉罩组[4(3,5)、4(4,5)、5(5,5)和5(5,5)](均P < 0.05)。鼻咽通气道组的麻醉诱导时间、苏醒时间和拔管时间分别为(47.8±4.3)秒、(4.1±1.7)分钟和(4.5±1.7)分钟,均短于喉罩组[(138.8±4.2)秒、(7.2±2.9)分钟和(8.1±2.7)分钟](均P < 0.05)。鼻咽通气道组患者拔管时的平均动脉压(MAP)为(84.9±10.2)mmHg(1 mmHg = 0.133 kPa),低于喉罩组[(93.2±7.5)mmHg](P < 0.05)。宫颈扩张时的呼气末二氧化碳分压(PetCO₂)为(22.0±5.9)mmHg,低于喉罩组[(37.2±2.2)mmHg](P < 0.05)。宫腔操作时和拔管时的PetCO₂分别为(45.5±6.7)和(41.6±4.5)mmHg,高于喉罩组[(39.2±4.1)mmHg和(38.6±3.6)mmHg](均P < 0.05)。鼻咽通气道组手术中呼吸抑制和体动的发生率分别为27.5%(11/40)和17.5%(7/40),均高于喉罩组[0和0](均P < 0.05)。术后嗜睡发生率为2.5%(1/40),低于喉罩组[17.5%(7/40)](P < 0.05)。两组均未出现严重体动或术中知晓。新型改良的通过鼻咽通气道保留自主呼吸的全身麻醉方法可提高患者术后恢复质量,减少不良反应的发生,有利于宫腔镜日间手术后患者快速康复。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验