CAJ | 학술논문

目的评价注射器活塞回弹法限制Supreme喉罩套囊压力的效果.方法择期喉罩通气下全麻患者60例,年龄22～64岁,性别不限,体重指数18 ～ 30 kg/m2,ASA分级Ⅰ或Ⅱ级.麻醉诱导后根据患者体重置入相应型号的Supreme喉罩(3号:≤50 kg,4号:＞50 kg).纤维支气管镜确定喉罩对位良好后,喉罩套囊充气至35 cmH2O行机械通气.用20 ml注射器在手持测压计监测下充气至喉罩套囊压力分别为60、80、100、120 cm H2O时停留10s,让注射器活塞自然回弹,记录活塞停止回弹时喉罩套囊内的压力及气道密闭压.结果注射器活塞停止回弹时,3号和4号喉罩的残余囊内压的95％可信区间均低于60 cm H2O,气道密闭压的95％可信区间均超过20 cm H2O.3号和4号Supreme喉罩的残余囊内压和气道密闭压比较差异无统计学意义(P＞0.05).结论 20 ml注射器活塞回弹法能够较好地防止Supreme喉罩套囊内压力过高.
목적 평개주사기활새회탄법한제Supreme후조투낭압력적효과.방법 택기후조통기하전마환자60례,년령22～64세,성별불한,체중지수18 ～ 30 kg/m2,ASA분급Ⅰ혹Ⅱ급.마취유도후근거환자체중치입상응형호적Supreme후조(3호:≤50 kg,4호:＞50 kg).섬유지기관경학정후조대위량호후,후조투낭충기지35 cmH2O행궤계통기.용20 ml주사기재수지측압계감측하충기지후조투낭압력분별위60、80、100、120 cm H2O시정류10s,양주사기활새자연회탄,기록활새정지회탄시후조투낭내적압력급기도밀폐압.결과 주사기활새정지회탄시,3호화4호후조적잔여낭내압적95％가신구간균저우60 cm H2O,기도밀폐압적95％가신구간균초과20 cm H2O.3호화4호Supreme후조적잔여낭내압화기도밀폐압비교차이무통계학의의(P＞0.05).결론 20 ml주사기활새회탄법능구교호지방지Supreme후조투낭내압력과고.
Objective To assess the efficacy of recoil of inflating syringe plunger in limiting laryngeal mask airway (LMA) cuff pressure.Methods Sixty ASA Ⅰ or Ⅱ patients aged 22-64 yr with body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were enrolled in this study.LMA Supreme (Laryngeal Mask Co.Singapore) size # 3 (for patients with body weight ≤50 kg) or # 4 (for patients with body weight ＞ 50 kg) was placed after induction of anesthesia.Correct position of LMA was confirmed by fiberoptic bronchoscopy.The LMA cuff was inflated to 60,80,100 and 120 cm H2O step by step using a 20 ml-syringe.The cuff pressure was measured with a monometer through a 3-way stopcock and maintained at each level for 10 seconds.The plunger was then allowed to recoil.The cuff pressure at the end of recoil (residual cuff pressure) was recorded.The patients were mechanically ventilated.The inspiratory pressure was limited to 30 cm H2 O.The airway pressure at which the air started to leak between LMA and larynx (leak pressure-Pleak) was recorded.Results The residual cuff pressure following the 4 inflating pressures was all ＜ 60 cm H2 O.The Pleak was ＞20 cm H2O.There was no significant difference in residual cuff pressure and Pleak between size # 3 and # 4.Conclusion Recoil of inflating syringe plunger can limit LMA pressure to safe level.