在胸部手术期间,自发通风与双流体管输入相结合:一种基于三年来141例病例的新麻醉方法
Zsolt Szabo1, Csongor Fabo2, Matyas Szarvas2
1Doctoral School of Multidisciplinary Medicine, University of Szeged, H-6720 Szeged, Hungary.
Journal of clinical medicine
|October 28, 2023
概括
用双光管输管 (SVI) 进行自发通风是胸部手术的安全和可行的技术. 这种方法显著减少了机械单肺通风的时间,并且对传统麻醉的转换率很低.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 由于呼吸道安全问题,非输入胸部手术的采用是有限的.
- 为了解决这些问题,开发了一种新的技术,即用双光管输管 (SVI) 进行自发通风,以解决这些问题.
- 本研究评估了SVI技术的可行性和局限性.
研究的目的:
- 评估胸部外科手术中使用双光管输管 (SVI) 自发通风的安全性和有效性.
- 确定SVI技术的可行性和局限性.
- 将SVI结果与传统麻醉管理进行比较.
主要方法:
- 麻醉诱导使用目标控制输注芬太尼和普罗波福与米瓦.
- 双光谱指数监测,以获得最佳的麻醉深度和用于输管治疗的短期肌肉放松.
- 胸口打开,然后进行局部透,神经阻塞和副脊椎阻塞;肌肉松剂停止以实现自发呼吸.
主要成果:
- 在2020年3月至2022年10月期间,进行了141次SVI手术.
- 在65.96%的病例中,自发呼吸足够;31.21%的病例需要压力支通风.
- 只有2.84%的病例需要转换为常规麻醉;平均最大CO2压力为59.01mmHg,平均最低O2和为93.96%.
结论:
- 用双光管输管自发通风是胸部手术的安全和可行的方法.
- 该SVI技术显著减少了76.5%的机械单肺通风时间.
- 麻醉剂转化为肌肉放松的速度很低,为2.8%.
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