[小型潮体积高通风缓解容易脊柱手术中的眼内和脑内压力升高:一项随机对照试验]
1Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
概括
小潮量高通风有效降低眼内压力 (IOP) 和视神经外直径 (ONSD) 在容易脊柱手术期间. 这种通风策略有助于在全身麻醉下的患者管理这些关键参数.
科学领域:
- 麻醉学和重症监护
- 神经外科和脊椎外科手术
- 眼科和眼睛生理学
背景情况:
- 在全身麻醉下躺卧的脊柱手术在控制内和眼内压力方面存在挑战.
- 在此类手术中,眼内压力升高 (IOP) 和视神经外直径 (ONSD) 是潜在的风险.
研究的目的:
- 评估小潮量高通风与常规通风对IOP和ONSD的影响.
- 为了确定不同通风策略的有效性,在接受倾向性脊柱手术的患者.
主要方法:
- 72名患者被随机分为两组:常规通风 (Vt 8mL/kg) 和小潮量高通风 (Vt 6 mL/kg).
- 测量IOP,ONSD和血液动力学/呼吸系统参数是在多个时间点进行的.
- 终潮二氧化碳 (etCO2) 在每个组的特定范围内保持.
主要成果:
- 在手术期间,IOP和ONSD都从基线显著增加,这两组在手术期间都显著增加.
- 与常规通风组相比,高通风组在T3和T4时显示出明显较低的IOP.
- 在T4的高通风组中,ONSD显着较低,而IOP显示与手术内etCO2.2的反向相关性.
结论:
- 小潮量高通风是一种有效的策略,可以减轻易患脊柱手术期间内压和ONSD的增加.
- 这种通风方法在这种手术背景下为控制眼睛和内压力提供了潜在的好处.
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