非输入管管的支气管镜式气管支气管外科手术,用脑电图监测静脉麻醉:可行性和结果
Yu Fang1, Ching-Kai Lin2,3, Zong-Han Yao2,3
1Department of Anesthesiology, National Taiwan University Hospital, Taipei.
Journal of thoracic disease
|June 17, 2024
概括
在支气管镜上进行的气管支气管外科手术 (BTS) 中,监控的非输入式麻醉是可行的,提供高成功率和快速恢复. 高度出血是主要风险,特别是在气管手术中,可能导致脱和ICU入院.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
背景情况:
- 由于共享的呼吸道和中央呼吸道阻塞,支气管镜式气管支气管手术 (BTS) 的麻醉具有挑战性.
- 监控麻醉与自发呼吸,利用电脑图衍生全静脉麻醉,为内管道输管提供了一个替代方案.
- 这种方法旨在在复杂的气道干预过程中保持气道透明度.
研究的目的:
- 评估BTS监测的非直管麻醉的可行性和结果.
- 确定与手术内脱和术后并发症相关的因素.
- 评估这种麻醉技术在呼吸道外科手术中的安全性和有效性.
主要方法:
- 在2019年10月至2022年8月期间,对92名接受非输管BTS的患者进行了回顾性分析.
- 采用了supraglottic气道装置和高流量鼻腔氧化.
- 收集和分析了手术内和手术后的数据.
主要成果:
- 在94.6%的患者中,手术成功完成;由于出血,3人需要转换为输管.
- 11%的患者经历了平均9分钟的脱度 (SpO2 <90%).
- 高度出血导致12.2%的门诊患者和7.8%的住院患者入院ICU;气管外科手术的脱时间更长.
结论:
- 监控非输管麻醉是一种可行的BTS技术,显示出高成功率,最小的并发症和快速的患者康复.
- 高度出血是最重要的不可预测风险,可能导致脱和,需要接受ICU治疗,特别是在气管阻塞的情况下.
- 这种麻醉策略为接受呼吸道干预的选定患者提供了安全有效的选择.
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