CAJ | 학술논문

目的探讨俯卧位全身麻醉手术的患者,在其清醒气管插管自行摆放俯卧位后再行全身麻醉诱导的临床可行性.方法选择30例需行全身麻醉下俯卧位手术的患者,分别采用纤维支气管镜引导清醒气管插管后,患者根据自身的舒适度配合医务人员摆放俯卧位.记录患者基础状态(T0)、插管过程(T1)和摆放体位(T2)时的血流动力学参数:收缩压(SBP)、舒张压(DBP)和心率(HR),并计算心率收缩压乘积(RPP)及参数的变化范围.结果 30例患者中28例均能顺利配合完成整个过程,成功28例(93.3％).在T1、T2时相SBP、DBP、HR和RPP数据比较T0均有增加,但仅有T1 DBP[(92.2±11.6) mmHg(1 mmHg =0.133 kPa)]增高较T0[(78.1 ±12.7) mmHg]差异有统计学意义(P＜0.05),且RPP最大值均小于22 000,T1、T2两个时相SBP、DBP、HR最大值较T0时相变化率均小于30％.结论全身麻醉下俯卧位手术的患者,在纤维支气管镜引导下清醒气管插管后患者自行摆放俯卧位是可行的.
목적 탐토부와위전신마취수술적환자,재기청성기관삽관자행파방부와위후재행전신마취유도적림상가행성.방법 선택30례수행전신마취하부와위수술적환자,분별채용섬유지기관경인도청성기관삽관후,환자근거자신적서괄도배합의무인원파방부와위.기록환자기출상태(T0)、삽관과정(T1)화파방체위(T2)시적혈류동역학삼수:수축압(SBP)、서장압(DBP)화심솔(HR),병계산심솔수축압승적(RPP)급삼수적변화범위.결과 30례환자중28례균능순리배합완성정개과정,성공28례(93.3％).재T1、T2시상SBP、DBP、HR화RPP수거비교T0균유증가,단부유T1 DBP[(92.2±11.6) mmHg(1 mmHg =0.133 kPa)]증고교T0[(78.1 ±12.7) mmHg]차이유통계학의의(P＜0.05),차RPP최대치균소우22 000,T1、T2량개시상SBP、DBP、HR최대치교T0시상변화솔균소우30％.결론 전신마취하부와위수술적환자,재섬유지기관경인도하청성기관삽관후환자자행파방부와위시가행적.
Objective To discuss the feasibility of patients accepting general anesthesia induction after lying in the prone position by themselves with awake endotracheal intubations.Methods 30 patients who needed prone position surgeries were selected.After an awake fiberoptic endotracheal intubation,the patients in the waking state lied in the prone position according to their own comfort with the guide of medical staff.The statistics of systolic blood pressure (SBP),diastolic blood pressure (DBP),and heart rate (HR) were recorded respectively in the basal state (T0),in the time of intubations (T1),in the time of the body turning (T2).The rate pressure product (RPP) and the changed of the parameter were also calculated.Results 30 of 32 patients completed the whole process guided by medical staff,30 were successful (93.8％).There was a slight increase in statistics of SBP,DBP,HR and RPP in phase T1,T2 compared with that in phase T0.But only in the DBP increase which T1 [(92.2 ± 1 1.6) mmHg (1 mmHg =0.133 kPa)] compared with that in phase T0 [(78.1 ± 12.7) mmHg] was statistical significance (P ＜ 0.05).And the maximum of RPP all less than 22 000.The changed in statistics of SBP,DBP,HR and RPP in phase T1,T2 compared with that in phase T0 were also less than 30％.Conclusion It is feasible that patients waiting for operations under general anesthesia lie in the prone position by themselves after awake flexible fiberoptic intubation.