Shorten G D, Armstrong D C, Roy W I, Brown L
Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.
Paediatr Anaesth. 1995;5(4):243-8. doi: 10.1111/j.1460-9592.1995.tb00292.x.
Upper airway patency can be compromised when children (or adults) receive sedative medication. The study examines the effect of two different positioning techniques (use of the 'sniff position pillow' (SPP) and shoulder elevation (SE) on maintenance of upper airway patency using MRI in 21 children sedated with intravenous pentobarbital (5-8 mg.kg-1). Children positioned on the SPP had a significantly greater degree of atlanto-occipital extension (P < 0.05), and a significantly greater nasopharyngeal diameter (P < 0.05) than those with shoulder elevation. The degree of atlanto-occipital extension was not significantly correlated with pharyngeal diameter (R = -0.68). No clinical signs of upper airway obstruction were noted and oxygen desaturation did not occur. Both positioning techniques were consistently associated with upper airway patency under the study conditions described. In obligate nose breathers to whom sedative agents are administered, the SPP is more likely to maintain nasopharyngeal patency than shoulder elevation.
当儿童（或成人）接受镇静药物治疗时，上呼吸道通畅性可能会受到影响。本研究使用MRI检查了两种不同的体位技术（使用“嗅物位枕头”（SPP）和抬高肩部（SE））对21名静脉注射戊巴比妥（5 - 8mg·kg-1）镇静的儿童上呼吸道通畅性维持的影响。与抬高肩部的儿童相比，使用SPP体位的儿童寰枕关节伸展程度显著更大（P < 0.05），鼻咽直径也显著更大（P < 0.05）。寰枕关节伸展程度与咽直径无显著相关性（R = -0.68）。未观察到上呼吸道梗阻的临床体征，也未发生氧饱和度下降。在所描述的研究条件下，两种体位技术均始终与上呼吸道通畅相关。对于接受镇静剂治疗的强迫性鼻呼吸者，SPP比抬高肩部更有可能维持鼻咽通畅。
