全麻诱导期成年患者的适宜面罩通气压力：实时超声测量胃窦部横截面积  

Optimal pressure for facemask ventilation during induction of general anesthesia in adult patients： real-time ultrasonographic measurement of antral cross-sectional area

作　　者：杭黎华[1] 卫世有 徐振锴 束薇薇[2] 陈远丰[2] 陈正[2] 施蕾蕾[2] 邵东华[2] 

机构地区：[1]江苏大学附属昆山医院麻醉科,苏州市215300 [2]江苏大学附属人民医院麻醉科,镇江市212002

出　　处：《中华麻醉学杂志》2017年第4期461-463,共3页Chinese Journal of Anesthesiology

摘　　要：目的采用实时超声测量胃窦部横截面积（CSA）确定全麻诱导期成年患者的适宜面罩通气压力。方法择期全麻下行手术患者60例，年龄18～60岁，BMI 20～25 kg/m^2，ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为5组（n＝12）：P10组、P13组、P16组、P19组和P22组。麻醉诱导后置入口咽通气道双手托下颌扣面罩，采用压力控制模式行面罩通气2 min。5组面罩通气压力分别为10、13、16、19和22 cmH2O。面罩通气前后采用实时超声测量CSA，记录呼吸参数。结果与P10组比较，P16组，P19组和P22组面罩通气后CSA〈340 mm^2例数减少，P13组、P16组、P19组及P22组潮气量≥6 ml/kg例数增加（P 〈 0.01）；5组适宜面罩通气例数依次为2、10、6、4和1，P13组最多（P 〈 0.01）。结论采用实时超声确定全麻诱导期适宜面罩通气压力为13 cmH2O，可保证患者充分供氧且可减少胃进气。Objective To determine the optimal pressure for facemask ventilation during induction of general anesthesia by real-time ultrasonographic measurement of antral cross-sectional area（CSA）in adult patients.Methods Sixty American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 18-60 yr, with body mass index of 20-25 kg/m^2, scheduled for elective operation under general anesthesia, were divided into 5 groups（n=12 each）using a random number table： P10 group, P13 group, P16 group, P19 group and P22 group.After induction of anesthesia, an oropharyngeal airway was inserted, and the patients were ventilated for a 2-min period in a pressure-controlled mode using the two-handed mask ventilation technique.The pressure for facemask ventilation was 10, 13, 16, 19 and 22 cmH2O in P10, P13, P16, P19 and P22 groups, respectively.The antral CSA was measured using real-time ultrasonography before and after facemask ventilation.Respiratory parameters were recorded.Results Compared with group P10, the number of patients in whom CSA〈340 mm^2 after facemask ventilation was significantly decreased in P16, P19 and P22 groups, and the number of patients in whom the tidal volume ≥ 6 ml/kg was increased in P13, P16, P19 and P22 groups（P〈 0.01）. The number of patients in whom optimal pressure for facemask ventilation was achieved was 2, 10, 6, 4 and 1 in P10, P13, P16, P19 and P22 groups, respectively, with the most cases in group P13（P 〈 0.01）.Conclusion The optimal pressure is 13 cmH2O for facemask ventilation during induction of general anesthesia when determined by real-time ultrasonographic measurement of antral CSA, and it can ensure adequate oxygen supply and reduce gastric insufflation in adult patients.

关 键 词：面罩 超声检查 呼吸 人工 

分 类 号：R614.2[医药卫生—麻醉学]