在没有神经肌肉阻断剂的情况下麻醉的肌患者的胸腔镜胸膜切除术的Univent管:一项观察性研究
Vo Van Hien1,2, Nguyen Huu Tu3, Nguyen Dang Thu1,4
1Department of Anesthesiology, Military Hospital 103, Vietnam Military Medical University, Ha Dong District, Hanoi, Vietnam.
Saudi journal of anaesthesia
|July 11, 2025
概括
联合管对于接受胸腔切除术而没有神经肌肉阻断剂 (NMBAs) 的肌痛神经衰竭 (MG) 患者是安全的. 较高的MG阶段改善了输管和手术条件,特别是右肺阻塞.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 呼吸系统医学 呼吸系统医学
背景情况:
- 骨髓灰质炎 (MG) 患者可能需要在没有神经肌肉阻断剂 (NMBAs) 的情况下进行全身麻醉进行手术.
- 在单肺通风过程中,univent管提供了灵活性和减少了气道创伤,这对具有挑战性的输内管是有益的.
研究的目的:
- 评估在MG患者中使用univent管进行胸膜切除术的安全性和可行性.
- 为了评估在没有NMBA的全身麻醉下得到的结果,并补充了局部呼吸道麻醉.
主要方法:
- 一个单一中心的前性观察性研究包括83名连续MG患者.
- 患者接受了胸腔镜胸膜切除术与无管输管,没有NMBA的全身麻醉和局部呼吸道麻醉.
- 关键结果包括输管条件,手术方面,以及手术内呼吸道/呼吸道并发症.
主要成果:
- 99%的患者实现了临床上可接受的输管条件 (80%很好,19%好);没有发生输管失败.
- 在89%的患者中,手术条件很好;右肺阻塞增强了肺缩和手术前景.
- 轻微的并发症包括支气管 (6%) 和声带损伤 (10%);术后喉痛和声在三天内消失.
结论:
- 在没有NMBAs管理的MG患者中,univent管是胸腔镜胸膜切除术的安全和有效选择.
- 较高的MG疾病阶段与更好的输管条件相关.
- 右侧支气管阻塞通过增强的肺缩促进了改善的手术条件.
相关概念视频
Tracheostomy: Procedure and Tubes
1.3K
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
1.3K
Skeletal Muscle Relaxants: Therapeutic Uses
624
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
624
Endoscopic Studies II: Thoracocentesis
522
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
522
Endotracheal Tube Extubation
1.5K
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
1.5K
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
91
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
91
Endotracheal Intubation I: Procedure
3.2K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
3.2K


