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脊柱框架对全身麻醉下俯卧位患者呼吸动力学变化的影响——一项前瞻性观察研究。

Effect of spine frame on the changes in respiratory dynamics in prone patients under general anaesthesia- a prospective, observational study.

作者信息

Kandasamy Preeti, Pujari Vinayak S, Channaiah Sandya Rani D

机构信息

Department of Anaesthesiology, MS Ramaiah Medical College, Bengaluru, Karnataka, India.

Department of Anaesthesiology, Manipal Hospitals, Bengaluru, Karnataka, India.

出版信息

Indian J Anaesth. 2023 Jul;67(7):609-613. doi: 10.4103/ija.ija_108_23. Epub 2023 Jul 14.

Abstract

BACKGROUND AND AIMS

The prone position is one of the common surgical positions used in clinical practice. Manoeuvring patients from supine to a prone position can impact respiratory dynamics and result in haemodynamic variations.

METHODS

This study included 64 patients and was conducted after obtaining approval from the ethics committee and registration of the trial. The primary objective was to evaluate the changes in peak inspiratory pressure (PIP), plateau pressure (P) and mean airway pressure (MAP) in patients undergoing surgery under general anaesthesia in the prone position with (Group S) and without (Group P) spine frame. The secondary objective was to evaluate and compare the variations in heart rate and blood pressure.

RESULTS

On turning the patient prone, there was statistically significant increase in median PIP (Group S 4 cmHO vs. Group P 0.5 cmHO, < 0.001), P (Group S 3.5 cmHO vs. Group P 1 cmHO, = 0.004) and dynamic compliance (Group S -5.513 vs. Group P -2.78, < 0.004).

CONCLUSIONS

Our study found that prone positioning with a spine frame led to a significantly greater increase in airway pressures and a decrease in dynamic compliance when compared to patients positioned prone without the spine frame.

摘要

背景与目的

俯卧位是临床实践中常用的手术体位之一。将患者从仰卧位转为俯卧位会影响呼吸动力学,并导致血流动力学变化。

方法

本研究纳入64例患者,研究在获得伦理委员会批准并进行试验注册后开展。主要目的是评估在全身麻醉下采用俯卧位手术的患者中,使用脊柱框架(S组)和不使用脊柱框架(P组)时吸气峰压(PIP)、平台压(P)和平均气道压(MAP)的变化。次要目的是评估和比较心率和血压的变化。

结果

患者转为俯卧位时,S组的PIP中位数(4 cmH₂O)与P组(0.5 cmH₂O)相比有统计学显著升高(P < 0.001),P(S组3.5 cmH₂O vs. P组1 cmH₂O,P = 0.004)和动态顺应性(S组 -5.513 vs. P组 -2.78,P < 0.004)。

结论

我们的研究发现,与未使用脊柱框架的俯卧位患者相比,使用脊柱框架的俯卧位会导致气道压力显著升高,动态顺应性降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d666/10436715/899294b87e93/IJA-67-609-g001.jpg

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