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Comparison of analgesic effects between programmed intermittent epidural boluses and continuous epidural infusion after cesarean section: a randomized controlled study. 剖宫产术后程序化间歇硬膜外注射与连续硬膜外输注镇痛效果的比较:随机对照研究。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.4097/kja.23726
Yu Jeong Bang, Heejoon Jeong, RyungA Kang, Ji-Hee Sung, Suk-Joo Choi, Soo-Young Oh, Tae Soo Hahm, Young Hee Shin, Yeon Woo Jeong, Soo Joo Choi, Justin Sangwook Ko

Background: This study aimed to compare the analgesic effects of programmed intermittent epidural boluses (PIEB) and continuous epidural infusion (CEI) for postoperative analgesia after elective cesarean section (CS).

Methods: Seventy-four women who underwent elective CS were randomized to receive either PIEB or CEI. The PIEB group received 4 ml-intermittent boluses of 0.11% ropivacaine every hour at a rate of 120 ml/h. The CEI group received a constant rate of 4 ml/h of 0.11% ropivacaine. The primary outcome was the pain score at rest at 36 h after CS. Secondary outcomes included the pain scores during mobilization, time-weighted pain scores, the incidence of motor blockade, and complications-related epidural analgesia during 36 h after CS.

Results: The pain score at rest at 36 h after CS was significantly lower in the PIEB group compared with that in the CEI group (3.0 vs. 0.0; median difference: 2, 95% CI [1, 2], P < 0.001). The mean time-weighted pain scores at rest and during mobilizations were also significantly lower in the PIEB group than in the CEI group (pain at rest; mean difference [MD]: 37.5, 95% CI [24.6, 50.4], P < 0.001/pain during mobilization; MD: 56.6, 95% CI [39.8, 73.5], P < 0.001). The incidence of motor blockade was significantly reduced in the PIEB group compared with that in the CEI group (P < 0.001).

Conclusions: PIEB provides superior analgesia with less motor blockade than CEI in postpartum women after CS, without any apparent adverse events.

背景:本研究旨在比较程序性间歇硬膜外栓剂(PIEB)和连续硬膜外输液(CEI)对择期剖宫产术(CS)术后镇痛的效果:74名接受择期剖宫产术的女性被随机分配到PIEB或CEI组。PIEB 组每小时以 120 毫升/小时的速度间歇注射 4 毫升 0.11% 罗哌卡因。CEI组接受4毫升/小时的0.11%罗哌卡因恒定注射。主要结果是 CS 后 36 小时休息时的疼痛评分。次要结果包括活动时的疼痛评分、时间加权疼痛评分、运动阻滞发生率和 CS 后 36 小时内硬膜外镇痛相关并发症:CS后36小时静息时的疼痛评分,PIEB组明显低于CEI组(3.0 vs. 0.0;中位数差异,2;95% CI:1,2;P < 0.001)。PIEB组在休息时和活动时的平均时间加权疼痛评分也显著低于CEI组(休息时疼痛:平均差异,37.5;95% CI,[24.6,50.4];P <0.001;活动时疼痛:平均差异,56.6;95% CI,[39.8,73.5];P <0.001)。与CEI组相比,PIEB组的运动阻滞发生率明显降低(P < 0.001):结论:与CEI相比,PIEB能为CS后的产后妇女提供更好的镇痛效果,同时减少运动阻滞,且无任何明显的不良反应。
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引用次数: 0
Perioperative management of patients with cardiac implantable electronic devices. 心脏植入式电子设备患者的围手术期管理。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-01-29 DOI: 10.4097/kja.23826
Minsu Kim, Chang Hee Kwon

The use of cardiac implantable electronic devices (CIEDs) has increased significantly in recent years. Consequently, more patients with CIEDs will undergo surgery during their lifetime, and thus the involvement of anesthesiologists in the perioperative management of CIEDs is increasing. With ongoing advancements in technology, many types of CIEDs have been developed, including permanent pacemakers, leadless pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy-pacemakers/defibrillators, and implantable loop recorders. The functioning of CIEDs exposed to an electromagnetic field can be affected by electromagnetic interference, potential sources of which can be found in the operating room. Thus, to prevent potential adverse events caused by electromagnetic interference in the operating room, anesthesiologists must have knowledge of CIEDs and be able to identify each type. This review focuses on the perioperative management of patients with CIEDs, including indications for CIED implantation to determine the baseline cardiovascular status of patients; concerns associated with CIEDs before and during surgery; perioperative management of CIEDs, including magnet application and device reprogramming; and additional perioperative provisions for patients with CIEDs. As issues such as variations in programming capabilities and responses to magnet application according to device can be challenging, this review provides essential information for the safe perioperative management of patients with CIEDs.

近年来,心脏植入式电子设备(CIED)的使用率大幅上升。因此,越来越多的 CIED 患者将在有生之年接受手术治疗,麻醉医生在 CIED 围手术期管理中的参与度也在不断提高。随着技术的不断进步,已开发出多种类型的 CIED,包括永久起搏器、无引线起搏器、植入式心脏除颤器、心脏再同步治疗起搏器/除颤器和植入式循环记录器。暴露在电磁场中的植入式心律转复除颤器的功能可能会受到电磁干扰的影响,而手术室中就有潜在的电磁干扰源。因此,为防止手术室内电磁干扰造成的潜在不良事件,麻醉医师必须了解 CIED 的相关知识,并能够识别每种类型的 CIED。本综述重点关注CIED患者的围术期管理,包括CIED植入的适应症,以确定患者的心血管基线状态;术前和术中与CIED相关的问题;CIED的围术期管理,包括磁铁应用和设备重新编程;以及CIED患者围术期的其他规定。由于不同设备的编程能力和对磁铁应用的反应等问题可能具有挑战性,本综述为 CIED 患者的安全围术期管理提供了重要信息。
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引用次数: 0
Response to "Comment on Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis". 回应对 "关于腹腔镜胆囊切除术的单次区域麻醉:系统综述和网络荟萃分析 "的评论。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-19 DOI: 10.4097/kja.23703
Alessandro De Cassai, Federico Geraldini
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引用次数: 0
Comparison of preemptive and preventive intravenous acetaminophen on opioid consumption in pediatrics undergoing posterior spinal fusion surgery: a randomized controlled trial. 在接受脊柱后路融合手术的儿科患者中,比较预先静脉注射对乙酰氨基酚和预防性静脉注射对乙酰氨基酚对阿片类药物消耗量的影响:随机对照试验。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-20 DOI: 10.4097/kja.23747
Yeon Ju Kim, Ha-Jung Kim, Sehee Kim, Hyungtae Kim, Choon Sung Lee, Chang Ju Hwang, Jae Hwan Cho, Young-Jin Ro, Won Uk Koh

Background: Posterior spinal fusion (PSF), commonly used for adolescent idiopathic scoliosis (AIS), causes severe postoperative pain. Intravenous (IV) administration of acetaminophen has shown promise for opioid-sparing analgesia; however, its analgesic effect and optimal timing for its standard use remain unclear. Our study aimed to evaluate the analgesic effect and optimal timing of IV acetaminophen administration in pediatric and adolescent patients undergoing PSF and requiring adequate pain control.

Methods: This prospective, randomized, triple-blind trial was conducted in patients aged 11-20 undergoing PSF. Participants were randomized into three groups: the preemptive group (received IV acetaminophen 15 mg/kg after anesthetic induction/before surgical incision), the preventive group (received IV acetaminophen 15 mg/kg at the end of surgery/before skin closure), and the placebo group. The primary outcome was cumulative opioid consumption during the first 24 h postoperatively.

Results: Among the 99 enrolled patients, the mean ± standard deviation (SD) amount of opioid consumption during the postoperative 24 h was 60.66 ± 23.84, 52.23 ± 22.43, and 66.70 ± 23.01 mg in the preemptive, preventive, and placebo groups, respectively (overall P = 0.043). A post hoc analysis revealed that the preventive group had significantly lower opioid consumption than the placebo group (P = 0.013). However, no significant differences between the groups were observed for the secondary outcomes.

Conclusions: The preventive administration of scheduled IV acetaminophen reduces cumulative opioid consumption without increasing the incidence of drug-induced adverse events in pediatric and adolescent patients undergoing PSF.

背景:脊柱后路融合术(PSF)常用于治疗青少年特发性脊柱侧凸(AIS),会引起严重的术后疼痛。静脉注射对乙酰氨基酚有望实现阿片类药物替代镇痛,但其镇痛效果和标准使用的最佳时机仍不明确。我们的研究旨在评估接受 PSF 且需要充分止痛的儿童和青少年患者静脉注射对乙酰氨基酚的镇痛效果和最佳用药时机:这项前瞻性、随机、三盲试验在 11-20 岁接受 PSF 的患者中进行。参与者被随机分为三组:抢先组(麻醉诱导后/手术切口前静脉注射对乙酰氨基酚 15 毫克/千克)、预防组(手术结束后/皮肤闭合前静脉注射对乙酰氨基酚 15 毫克/千克)和安慰剂组。主要结果是术后 24 小时内阿片类药物的累计用量:结果:在 99 名入选患者中,抢先治疗组、预防治疗组和安慰剂组术后 24 小时内阿片类药物消耗量的平均值(± 标准差,SD)分别为 60.66 ± 23.84 毫克、52.23 ± 22.43 毫克和 66.70 ± 23.01 毫克(总 P = 0.043)。事后分析显示,预防组的阿片类药物用量明显低于安慰剂组(p = 0.013)。然而,在次要结果方面,各组间未观察到明显差异:预防性静脉注射对乙酰氨基酚可减少接受 PSF 的儿童和青少年患者的阿片类药物累积用量,同时不会增加药物引起的不良事件的发生率。
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引用次数: 0
The minimum effective concentration (MEC90) of bupivacaine for an ultrasound-guided suprainguinal fascia iliaca compartment block for analgesia in knee surgery: a dose-finding study. 超声引导下髂腹股沟上筋膜室阻滞用于膝关节手术镇痛的布比卡因最低有效浓度(MEC90):一项剂量摸底研究。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.4097/kja.23710
Caner Genc, Serkan Tulgar, Murat Unal, Ahmet Serhat Genc, Lokman Kehribar, Basar Erdivanli, Kris Vermeylen, Ersin Koksal

Background: In recent years, the suprainguinal fascia iliaca compartment block (SFICB) has become more common in clinical practice. This assessor-blinded dose-finding study aimed to determine the minimum effective concentration (MEC90, MEC95) of bupivacaine for a single-injection SFICB in patients undergoing arthroscopic anterior cruciate ligament repair.

Methods: This prospective study was conducted at a tertiary hospital (postoperative recovery room and ward). The SFICB was performed as a postsurgical intervention after spinal anesthesia. Seventy patients were allocated using the biased-coin design up-and-down sequential method. The ultrasound-guided SFICB was performed using different bupivacaine concentrations, and standard multimodal analgesia was administered to all patients. Block success was defined as the absence of pain or presence of only tactile sensation during the pinprick test conducted on the anterior and lateral regions of the mid-thigh six hours postoperatively.

Results: According to isotonic regression and bootstrap CIs, the MEC90 value of bupivacaine for a successful SFICB was 0.123% (95% CI [0.098, 0.191]) and the MEC95 value was 0.188% (95% CI [0.113, 0.223]).

Conclusions: Our study showed that the MEC90 and MEC95 values for bupivacaine administered via an SFICB for analgesia were 0.123% and 0.188%, respectively. One advantage of using lower concentrations of bupivacaine is the associated reduction in quadriceps weakness.

背景:近年来,髂腹股沟上筋膜室阻滞(SFICB)在临床实践中越来越常见。这项评估者盲法剂量调查研究旨在确定布比卡因在关节镜前十字韧带修复术患者中单次注射 SFICB 的最低有效浓度(MEC90、MEC95):这项前瞻性研究在一家三级医院(术后恢复室和病房)进行。SFICB是在脊髓麻醉后进行的术后干预。采用偏向硬币设计的上下顺序法分配了 70 名患者。所有患者均在超声引导下使用不同浓度的布比卡因进行 SFICB,并采用标准的多模式镇痛。阻滞成功的定义是术后6小时在大腿中部前侧和外侧区域进行针刺试验时无疼痛或仅有触觉:根据等容回归和自举CIs,布比卡因对SFICB成功的MEC90值为0.123%(95% CI:0.098-0.191),MEC95值为0.188%(95% CI:0.113-0.223):我们的研究表明,通过 SFICB 给予布比卡因镇痛的 MEC90 和 MEC95 值分别为 0.123% 和 0.188%。使用较低浓度布比卡因的优点之一是可减少股四头肌无力。
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引用次数: 0
Programmed intermittent epidural bolus: a viable alternative to traditional methods? 程序化间歇性硬膜外栓塞:传统方法的可行替代方案?
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-05-23 DOI: 10.4097/kja.24306
Seunguk Bang
{"title":"Programmed intermittent epidural bolus: a viable alternative to traditional methods?","authors":"Seunguk Bang","doi":"10.4097/kja.24306","DOIUrl":"10.4097/kja.24306","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of the Disposcope endoscope for awake orotracheal intubation in an elderly patient with a large vocal cord polyp -a case report. 使用 Disposcope 内窥镜为患有巨大声带息肉的老年患者进行清醒气管插管:病例报告。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-11 DOI: 10.4097/kja.23810
Duo Yang, Sen Li, Jinxin Lan, Shujun Ye, Longsheng Zhang

Background: Vocal cord polyps are commonly encountered in the otorhinolaryngology department. The risk of anesthesia is high in patients with large vocal cord polyps. Awake intubation with appropriate airway tools provides a favorable safety profile.

Case: We present the case of a 60-year-old male patient who had been suffering from a large vocal cord polyp for 16 years. Electronic laryngoscopy revealed that the vocal cord polyp was approximately 1.5 cm in diameter. The polyp had a pedicle and demonstrated synchronous motion with respiratory excursion. It covered almost the entire glottic area during inspiration and moved away from the glottis during expiration. A Disposcope endoscope was used for awake tracheal intubation, and the surgery was completed successfully.

Conclusions: The Disposcope endoscope can be a useful option for awake orotracheal intubation in cases of anticipated difficult intubation and difficult facemask ventilation.

背景:声带息肉是耳鼻喉科常见病。巨大声带息肉患者的麻醉风险很高。使用适当的气道工具进行清醒插管具有良好的安全性:本病例是一名 60 岁男性患者的病例,他患有巨大声带息肉已有 16 年之久。电子喉镜检查显示,声带息肉直径约为 1.5 厘米。息肉有蒂,与呼吸运动同步。它在吸气时几乎覆盖整个声门区域,呼气时则远离声门。使用 Disposcope 内窥镜进行了清醒气管插管,手术顺利完成:结论:在预计插管困难和面罩通气困难的病例中,Disposcope 内窥镜是清醒气管插管的有效选择。
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引用次数: 0
Intraoperative tourniquet-induced hyperthermia in a pediatric patient: a forgotten association -a case report. 一名儿科患者术中止血带引发的高热:一种被遗忘的关联。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-01-04 DOI: 10.4097/kja.23655
Tarek Tageldin, Muhammad Jaffar Khan, Temur Baykuziyev, Haitham Ahmed

Background: The intraoperative use of tourniquets is associated with several complications, including hyperthermia. We present the first documented case of tourniquet-induced hyperthermia in a pediatric patient at our institution.

Case: A 5-year-old female with no past medical history underwent tendon release surgery for congenital talipes equinovarus under general anesthesia. Following inflation of a pneumatic tourniquet to a pressure of 250 mmHg on her left thigh, the patient experienced a gradual increase in body temperature. Despite the implementation of cooling measures, the temperature continued to increase until it plateaued. The hyperthermia gradually resolved upon deflation of the tourniquet.

Conclusions: Tourniquet-induced hyperthermia should be considered as a potential cause of intraoperative hyperthermia, particularly in the absence of typical signs of malignant hyperthermia. Early recognition and appropriate management, including deflation of the tourniquet and implementation of cooling measures, are crucial for preventing potential complications associated with hyperthermia.

背景:术中使用止血带会引发多种并发症,包括高热。本院记录了首例止血带诱发高热的儿科病例:病例:一名既往无病史的 5 岁女性在全身麻醉下接受了先天性马蹄内翻足的肌腱松解手术。在左大腿上的气压止血带压力达到 250 mmHg 后,患者的体温逐渐升高。尽管采取了降温措施,但体温仍持续上升,直至稳定下来。止血带放气后,高热症状逐渐缓解:结论:止血带引发的高热应被视为术中高热的潜在原因,尤其是在没有恶性高热典型症状的情况下。早期识别和适当处理,包括放掉止血带和采取降温措施,对于预防与高热相关的潜在并发症至关重要。
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引用次数: 0
Comparison of effects of telmisartan versus valsartan on post-induction hypotension during noncardiac surgery: a prospective observational study. 比较替米沙坦和缬沙坦对非心脏手术诱导后低血压的影响:前瞻性观察研究。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-05 DOI: 10.4097/kja.23658
Chung-Sik Oh, Jun Young Park, Seong-Hyop Kim

Background: Telmisartan is considered more potent than valsartan. Hemodynamic response during anesthesia induction may be influenced by anti-hypertension (HTN) medication. The present study compared the effect of anti-HTN medications on post-induction hypotension during noncardiac surgeries.

Methods: This observational study standardized the anesthetic regimen across patients, with hypotension defined as mean blood pressure (BP) of less than 65 mmHg. The hemodynamic changes within 5 min before and after endotracheal intubation, and within 10 min before and after surgical incision were measured. Transthoracic echocardiographic evaluation of the left ventricle (LV) during anesthesia induction was performed. The primary endpoint was the decline in mean BP after anesthetic administration in telmisartan and valsartan groups. Multivariate logistic regression analysis was used to identify predictors of post-induction hypotension.

Results: Data from 157 patients undergoing noncardiac surgery were analyzed. No significant differences were found in mean BP decline between the two groups during anesthesia induction. Hemodynamic changes and LV ejection fraction (EF) during anesthesia induction were similar between the groups. Age and preoperative initial mean BP in operation room (OR) were associated with post-induction hypotension in both groups.

Conclusions: The angiotensin receptor blocker (ARB) type did not influence post-induction hypotension during anesthesia induction. Age and preoperative initial mean BP in OR were associated with post-induction hypotension in patients taking ARBs.

背景:替米沙坦被认为比缬沙坦更有效。麻醉诱导期间的血流动力学反应可能会受到抗高血压(HTN)药物的影响。本研究比较了抗高血压药物对非心脏手术诱导后低血压的影响:这项观察性研究对不同患者的麻醉方案进行了标准化,低血压定义为平均血压(BP)低于 65 mmHg。测量了气管插管前后 5 分钟内和手术切口前后 10 分钟内的血流动力学变化。在麻醉诱导期间对左心室(LV)进行经胸超声心动图评估。主要终点是替米沙坦组和缬沙坦组麻醉后平均血压的下降情况。多变量逻辑回归分析用于确定诱导后低血压的预测因素:结果:分析了 157 名非心脏手术患者的数据。两组患者在麻醉诱导期间的平均血压下降无明显差异。两组患者在麻醉诱导期间的血流动力学变化和左心室射血分数(EF)相似。两组患者的年龄和术前手术室(OR)初始平均血压均与诱导后低血压有关:结论:在麻醉诱导期间,血管紧张素受体阻滞剂(ARB)的类型不会影响诱导后低血压。服用血管紧张素受体阻滞剂的患者的年龄和术前手术室初始平均血压与诱导后低血压有关。
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引用次数: 0
Comparison of lung aeration loss in open abdominal oncologic surgeries after ventilation with electrical impedance tomography-guided PEEP versus conventional PEEP: a pilot feasibility study. 电阻抗断层扫描引导 PEEP 与传统 PEEP 通气后开放式腹部肿瘤手术肺通气损失的比较:一项试验性可行性研究。
IF 2.9 4区 医学 Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-05 DOI: 10.4097/kja.23858
A R Karthik, Nishkarsh Gupta, Rakesh Garg, Sachidanand Jee Bharati, M D Ray, Vijay Hadda, Sourabh Pahuja, Seema Mishra, Sushma Bhatnagar, Vinod Kumar

Background: Existing literature lacks high-quality evidence regarding the ideal intraoperative positive end-expiratory pressure (PEEP) to minimize postoperative pulmonary complications (PPCs). We hypothesized that applying individualized PEEP derived from electrical impedance tomography would reduce the severity of postoperative lung aeration loss, deterioration in oxygenation, and PPC incidence.

Methods: A pilot feasibility study was conducted on 36 patients who underwent open abdominal oncologic surgery. The patients were randomized to receive individualized PEEP or conventional PEEP at 4 cmH2O. The primary outcome was the impact of individualized PEEP on changes in the modified lung ultrasound score (MLUS) derived from preoperative and postoperative lung ultrasonography. A higher MLUS indicated greater lung aeration loss. The secondary outcomes were the PaO2/FiO2 ratio and PPC incidence.

Results: A significant increase in the postoperative MLUS (12.0 ± 3.6 vs 7.9 ± 2.1, P < 0.001) and a significant difference between the postoperative and preoperative MLUS values (7.0 ± 3.3 vs 3.0 ± 1.6, P < 0.001) were found in the conventional PEEP group, indicating increased lung aeration loss. In the conventional PEEP group, the intraoperative PaO2/FiO2 ratios were significantly lower but not the postoperative ratios. The PPC incidence was not significantly different between the groups. Post-hoc analysis showed the increase in lung aeration loss and deterioration of intraoperative oxygenation correlated with the deviation from the individualized PEEP.

Conclusions: Individualized PEEP appears to protect against lung aeration loss and intraoperative oxygenation deterioration. The advantage was greater in patients whose individualized PEEP deviated more from the conventional PEEP.

背景:现有文献缺乏有关理想术中呼气末正压(PEEP)的高质量证据,无法最大限度地减少术后肺部并发症(PPCs)。我们假设,应用由电阻抗断层扫描(EIT)得出的个体化 PEEP 可降低术后肺通气损失的严重程度、氧合作用的恶化以及 PPC 的发生率:对 36 名接受开放式腹部肿瘤手术的患者进行了一项试验性可行性研究。这些患者被随机分配接受个体化 PEEP 或 4 cm H2O 的常规 PEEP。主要结果是个体化 PEEP 对术前和术后肺部超声波检查得出的改良肺部超声波评分 (MLUS) 变化的影响。MLUS 越高表明肺通气损失越大。次要结果是 PaO2/FIO2 比值和 PPC 发生率:结果:常规 PEEP 组术后 MLUS 明显增加(12 ± 3.6 vs 7.9 ± 2.1,P < 0.001),术后与术前 MLUS 值差异明显(7.0 ± 3.3 vs 3.0 ± 1.6,P < 0.001),表明肺通气损失增加。在常规 PEEP 组,术中 PaO2/FIO2 比率显著降低,但术后比率没有显著降低。两组的 PPC 发生率无明显差异。事后分析表明,肺通气损失的增加和术中氧合情况的恶化与偏离个体化 PEEP 有关:结论:个体化 PEEP 似乎可以防止肺通气损失和术中氧合恶化。个体化 PEEP 与常规 PEEP 偏差较大的患者的优势更大。
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引用次数: 0
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Korean Journal of Anesthesiology
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