您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (11): 125-127.

• 论文 • 上一篇    下一篇

不同头颈位对LMA-SupremeTM间歇正压通气时口咽漏气压的影响

王文,王建光,刘海健,翁浩,徐振兴,谢坤峰   

  1. 上海交通大学附属第六人民医院奉贤分院麻醉科, 上海  201400
  • 收稿日期:2011-06-21 出版日期:2011-11-10 发布日期:2011-11-10
  • 通讯作者: 王建光(1973- ),男,副教授,主要从事临床麻醉与疼痛诊疗研究。 E-mail: wangjg5158@sina.com.cn
  • 作者简介:王文(1978- ),男,硕士,主治医师,主要从事临床麻醉的研究。
  • 基金资助:

    上海市奉贤区科委课题资助(200903)

Influence of head and neck position on oropharyngeal leak pressure with LMA-SupremeTM during intermittent positive pressure ventilation

WANG Wen, WANG Jian-guang, LIU Hai-jian, WENG Hao, XU Zhen-xing, XIE Kun-feng   

  1. Department of Anesthesiology, Fengxian Central Hospital, Shanghai 201400, China
  • Received:2011-06-21 Online:2011-11-10 Published:2011-11-10

摘要:

目的   评价不同头颈位对LMA-SupremeTM(SLMA)间歇正压通气时口咽漏气压(OLP)的影响。方法   妇科全麻手术患者60例,麻醉诱导后插入SLMA行间歇正压通气,设定喉罩气囊压(ICP)为60cm H2O。喉罩插入即刻,机械通气后60min分别测量正中位、前屈位、旋转位、后仰位四个头颈位时的OLP和ICP。统计各头颈位正压通气时漏气率。分别在四个头颈位通过引流管插入润滑后的胃管,记录胃管插入成功率并经通气导管插入纤维支气管镜(FOB),采用FOB分级法评价喉罩解剖位置。结果   喉罩置入即刻和机械通气后60min的OLP,前屈位>正中位>后仰位,旋转位与正中位比较无明显差异(P<0.05)。ICP在前屈位大于正中位,后仰位小于正中位,旋转位与正中位比较无明显差异。各种头颈位下患者喉罩解剖位置FOB分级无差异;前屈位时胃管插入成功率低于其他头颈位。结论   头前屈位可改善SLMA气道密闭性,适度前屈患者头部是改善SLMA正压通气效果的有效方法。相对于正中位,旋转位不影响SLMA通气效果,而后仰位降低SLMA气道密闭性。

关键词: LMA-SupremeTM;头颈位;口咽漏气压;气囊压

Abstract:

 Objective   To evaluate the influence of head and neck position on oropharyngeal leak pressure with LMA-SupremeTM during intermittent positive pressure ventilation. Methods   Sixty anaesthetized adult female patients  were studied. The laryngeal mask airway  was inserted into each patient and the cuff was inflated to an intra-cuff pressure(ICP)of 60cm H2O. The oropharyngeal leak pressure(OLP), intra-cuff pressure, and leakage rate were determined at four different head and neck position (neutral, flexion, rotation and extension) at the time after the insertion and 60min after operation. Also, the anatomical position of the airway tube and drainage tube were also documented. Results   Compared with the neutral position, the oropharyngeal leak pressure and intracuff pressure were higher in flexion, but lower in extension in 0 and 60min. Changes in head and neck position did not alter the anatomical position of the airway tube, but the drainage rate was lower in extension than the others. Conclusion   Head flexion can improve airway sealing. Appropriate head flexion is an effective way to improve positive pressure ventilation. Caution should be warranted when using LMA-SupremeTM in extension as airway sealing is decreased in this position.

Key words:  LMA-SupremeTM;  Head and neck position; Oropharyngeal leak pressure;  Intracuff pressure

中图分类号: 

  • R614.2
[1] 李兴华1,类振1,李景新2,孟涛1,张心雨2,于金贵1. 不同静脉麻醉药对大鼠结肠纵形肌收缩活动的影响[J]. 山东大学学报(医学版), 2012, 50(1): 72-75.
[2] 孟涛1,张心雨2,李兴华2,于金贵1. 吗啡和芬太尼对心内直视手术患者全身炎性反应和心脏功能影响的比较[J]. 山东大学学报(医学版), 2011, 49(2): 102-105.
[3] 张继如,张焰,朱小莲. 七氟烷静吸复合麻醉控制性降压用于鼻内镜手术的效果[J]. 山东大学学报(医学版), 2010, 48(8): 128-130.
[4] 辛德乾,张孟元,徐艳冰,王公明. 小剂量氯胺酮对心内直视手术患者心肺转流后脑损伤的影响[J]. 山东大学学报(医学版), 2010, 48(3): 134-137.
[5] . 利用麻醉气体监护仪床旁测定吸入麻醉药血药浓度[J]. 山东大学学报(医学版), 2009, 47(9): 86-88.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!