[1]刘 瑶,吴赞情△,董补怀.不同气管导管套囊压力对腹腔镜胆囊切除术全身麻醉患者拔管时心血管反应的影响*[J].陕西医学杂志,2019,(8):987-989，993.
　LIU Yao,WU Zanqing,DONG Buhuai..Effects of different endotracheal tube cuff pressure on cardiovascular response during endotracheal extubation of general anesthesia[J].,2019,(8):987-989，993.
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不同气管导管套囊压力对腹腔镜胆囊切除术全身麻醉患者拔管时心血管反应的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
987-989，993
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Effects of different endotracheal tube cuff pressure on cardiovascular response during endotracheal extubation of general anesthesia
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.007
作者:
刘 瑶; 吴赞情△; 董补怀
西安交通大学附属红会医院麻醉科（西安 710054）
Author(s):
LIU Yao;  WU Zanqing;  DONG Buhuai.
Department of Anesthesiology,  Honghui Hospital Affiliated to Xi’an Jiaotong University （Xi’an 710054）
关键词:
全身麻醉; 腹腔镜胆囊切除术; 套囊压力; 气管拔管; 心血管反应;  心率变异性
Keywords:
Key words General anaesthesia;  Laparoscopic cholecystectomy; Cuff pressure ; Extubation; Cardiovascular〖LM〗 response; Heart rate variability
分类号:
R614.2
文献标志码:
A
摘要:
摘 要 目的：观察不同气管导管套囊压力对腹腔镜胆囊切除术全身麻醉患者气管拔管时心血管反应的影响。方法：选择60例在全身麻醉下行腹腔镜胆囊切除手术的患者，ASA分级Ⅰ～Ⅱ级，随机分为两组，各30例，H组即高压组(套囊压力为30 cmH2O)，L组即低压组(套囊压为20 cmH2O)。麻醉诱导依次给予咪达唑仑0.05 mg/kg、舒芬太尼0.5 μg/kg、依托咪酯0.3 mg/kg，待意识消失后给予罗库溴铵1 mg/kg，1.5 min后行气管插管，确认气管导管位置正确后将气管套囊注气，用压力表测定套囊压力，L组压力控制在20 cmH2O，H组压力控制在30 cmH2O。连接麻醉机行机械通气，维持PETCO2在35～45 mmHg，术中靶控输注丙泊酚及瑞芬太尼，手术结束停药，静脉注射阿托品0.1 mg/kg、新斯的明20 μg/kg。分别记录患者在麻醉诱导前(T0)，气管插管时(T1)，气管拔管时(T2)，气管拔管后3 min(T3)的心率变异性（HRV）、收缩压（SDP）、舒张压（DBP）及心率（HR）,并计算收缩压与心率的乘积(RPP)及两组不良事件发生情况。结果：与T0时点比较，两组 T1、T2时点的SBP、DBP、HR、RPP增加(P<0.05),T3时点的SBP、DBP、HR、RPP差异无统计学意义(P＞0.05)。H组T1 、T2时点的HR较L组同时点升高(P<0.05),H组T1、T2时点的RPP较L组同时点升高(P<0.05)。结论：降低气管导管套囊压力有助于减轻腹腔镜胆囊切除术患者全身麻醉气管拔管期的心血管反应。
Abstract:
Abstract Objective：To observe the effect of different endotracheal tube cuff pressure on cardiovascular response of patients,who underwent endotracheal extubation of general anesthesia.Methods：A total of 60 patients,who were scheduled to undergo laparoscopic cholecystectomy under general anesthesia and classified as class Iaccording to American Society of Anesthesiologists(ASA) criteria,were enrolled and randomly divided into high pressure group(cuff pressure 30 cmH2O)and low pressure group(cuff pressure 20 cmH2O) .Both two groups were intravenously given midazolam 0.05 mg/kg, sufentanil 0.5μg/kg and etomidate 0.3 mg/kg in turn.Upon the patients losing consciousness, rocuronium1 mg/kg was injected intravenously for induction,and then intubation was conducted. HRV,Systolic blood pressure(SBP)，diastolic blood pressure(DBP)and heart rate(HR)were recorded, before anesthesia induction(T0),intubation(T1), extubation(T2) ,and 3minutes after extubation (T3),the rate-pressure product(RPP) was calculated,complicationgs were recorded.Results：Compare with T0, the two groups in patients’blood pressure ,HR and RPP of T1 and T2 were significantly higher(P＜0.05).There was no statistically significant difference between T0 and T3(P＞0.05) .At T1 and T2,the HR in high pressure group were significantly higher than those in low pressure group(P＜0.05). At T1 and T2,the RPP in high pressure group were significantly lower than those in low pressure group(P＜0.05).Conclusion：To control the cuff pressure of endotracheal tube has certain effect on relieving the cardiovascular response during endotracheal extubation of general anesthesia ．

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备注/Memo

备注/Memo:
*中国博士后科研基金资助面上项目（2016M590965）
更新日期/Last Update: 2019-08-13