儿童使用氟烷时的自主通气。气管内插管与喉罩气道的比较研究。

Spontaneous ventilation with halothane in children. A comparative study between endotracheal tube and laryngeal mask airway.

作者信息

Reignier J, Ben Ameur M, Ecoffey C

机构信息

Département d'Anesthésie-Réanimation, Hôpital de Bicêtre, Université Paris--Sud, Le Kremlin Bicêtre, France.

出版信息

Anesthesiology. 1995 Oct;83(4):674-8. doi: 10.1097/00000542-199510000-00005.

DOI:10.1097/00000542-199510000-00005

PMID:7574045

Abstract

BACKGROUND

It has been reported that, in children breathing spontaneously via an endotracheal tube, halothane depresses ventilation with paradoxic inspiratory movement. Endotracheal tubes have a higher airflow resistance than do laryngeal mask airways (LMAs). Therefore, the aim of this study was to compare spontaneous ventilation via the LMA with that via the endotracheal tube in children anesthetized with halothane.

METHODS

The authors studied two groups of 6-24-month-old children with no cardiorespiratory and neurologic disorders, undergoing elective minor surgery with halothane anesthesia: one group breathing via LMA (n = 10) and one group breathing via endotracheal tube (n = 10). They measured tidal volume, respiratory rate, minute ventilation, and end-tidal CO2. They assessed paradoxic inspiratory movement using amplitude index and phase delay index.

RESULTS

Age and weight were similar in both groups. Mean +/- SD tidal volume (7.5 +/- 1.9 ml/kg in the LMA group vs. 5.3 +/- 1.1 ml/kg in the endotracheal tube group; P < 0.05) and minute ventilation (325 +/- 105 ml.min-1.kg-1 in the LMA group vs. 246 +/- 38 ml.min-1.kg-1 in the endotracheal tube group; P < 0.05) were lower in the endotracheal tube group. The phase delay index (18 +/- 11% in the LMA group vs. 41 +/- 19% in the endotracheal tube group; P < 0.05) and the amplitude index (25 +/- 43% in the LMA group vs. 74 +/- 72% in the endotracheal tube group; P < 0.05) were significantly smaller with the LMA than with the endotracheal tube.

CONCLUSIONS

In 6-24-month-old children anesthetized with halothane, paradoxic inspiratory movement is less when breathing through an LMA than through an endotracheal tube.

摘要

背景

据报道，在通过气管内导管自主呼吸的儿童中，氟烷会抑制通气并伴有反常吸气运动。气管内导管的气流阻力高于喉罩气道（LMA）。因此，本研究的目的是比较在氟烷麻醉的儿童中，通过LMA的自主通气与通过气管内导管的自主通气情况。

方法

作者研究了两组6至24个月大、无心肺和神经系统疾病、接受氟烷麻醉下择期小手术的儿童：一组通过LMA呼吸（n = 10），另一组通过气管内导管呼吸（n = 10）。他们测量了潮气量、呼吸频率、分钟通气量和呼气末二氧化碳。他们使用幅度指数和相位延迟指数评估反常吸气运动。

结果

两组的年龄和体重相似。气管内导管组的平均±标准差潮气量（LMA组为7.5±1.9 ml/kg，气管内导管组为5.3±1.1 ml/kg；P < 0.05）和分钟通气量（LMA组为325±105 ml·min⁻¹·kg⁻¹，气管内导管组为246±38 ml·min⁻¹·kg⁻¹；P < 0.05）较低。LMA组的相位延迟指数（18±11%，气管内导管组为41±19%；P < 0.05）和幅度指数（LMA组为25±43%，气管内导管组为74±72%；P < 0.05）明显小于气管内导管组。