Xu T W, Liu J, Ding Y X
Department of Anesthesia, Kunming General Hospital PLA, Chengdu China.
Zhonghua Hu Li Za Zhi. 1997 Jan;32(1):6-8.
The effects of position change on respiration and circulation of 42 patients during spinal operations were investigated in this study. The results showed that, if the patient was placed on the operation position following the administration of the anesthesia, the changes of respiration (f, VT, MV) and circulation (SBP, HR) were significant (P < 0.01, 0.05). On the contrary, if the patient was placed in the operation position and then started the anesthesia, the respiratory and circulatory changes were comparatively stable (P > 0.05). The authors concluded that: 1. for the cases undergoing spinal operations, it is advisable to place the patient in the operation position first and then start the anesthesia; 2. for the critical cases, a tolerable position should be adopted; 3. during the adjustment of the position of the patient, the clavicle and the ilium should be used as the fulcrum so as to avoid driect contact of the chest and abdoment with the operation table, thus to minimze interference on the respiratory and circulatory functions.
本研究调查了42例患者在脊柱手术期间体位改变对呼吸和循环的影响。结果显示，如果在麻醉给药后将患者置于手术体位，呼吸（频率、潮气量、分钟通气量）和循环（收缩压、心率）的变化显著（P<0.01,0.05）。相反，如果先将患者置于手术体位然后开始麻醉，呼吸和循环变化相对稳定（P>0.05）。作者得出结论：1.对于接受脊柱手术的病例，建议先将患者置于手术体位然后开始麻醉；2.对于重症病例，应采用可耐受的体位；3.在调整患者体位时，应以锁骨和髂骨为支点，避免胸部和腹部直接接触手术台，从而尽量减少对呼吸和循环功能的干扰。
