普通麻醉机高频通气在硬质支气管镜手术中的运用

High frequency ventilation provided with anesthesia machine during interventional rigid bronchoscopy

摘要:

摘要：目的??评价普通麻醉机高频通气在硬质支气管镜手术中运用的安全性。方法?连续47例次气道手术患者，麻醉诱导采用丙泊酚1.5～2.0?mg/kg和瑞芬太尼1.0～2.0μg/kg，之后持续输注丙泊酚8.0～10.0?mg/（kg·h）和瑞芬太尼5.0～10.0μg/（kg·h），硬质支气管镜插入气管后接Dr?ger麻醉机行高频通气（300?ml，60次/min）。分别在术前、手术15?min、30?min和术毕进行动脉血气分析。记录患者围术期低氧血症的发生情况。结果?所有患者均顺利完成手术，手术时间为（67.8±19.8）min。围术期最低血氧饱和度（SpO2）为（95.3±8.4）%，SpO2下降低于90%共6次，其中诱导硬质支气管镜插入气管期2例次，手术操作期4例次。术中血气分析显示术中存在轻度高碳酸血症。结论?普通麻醉机高频通气可以用于硬质支气管镜手术麻醉。

Abstract:

Abstract: Objective?To evaluate the safety of high frequency ventilation provided by anesthesia machine during interventional rigid bronchoscopy.?Methods?47 consecutive patients underwent rigid brochoscopy precedures were enrolled into the study. Anesthesia was induced with propofol 2.0 mg/kg and remifentanil 1.0?~?2.0?μg/kg, immediately followed by infusions of propofol, 8.0?~?10.0?mg/(kg·h), and remifentanil, 5.0?~?10.0?μg/(kg·h). When rigid bronchoscope was inserted into trachea, high frequency ventilation (tidal volume of 300?ml and frequency of 60 bpm) provided with anesthesia machine (Dr?ger, Germany) was initiated. Arterial blood gas analysis were performed at baseline, 15 min and 30 min after the surgery and at the end of the surgery. Episodes of hypoxemia were recorded. ?Results?47 cases were successively completed. Duration of surgery was (67.8?±?19.8) min. The lowest oxygen saturation were (95.3?±?8.4)%. Episods of oxygen saturation less than 90% occurred seven times. Two times occurred during brochoscopy insertion and other four times occurred during the operation. Arterial blood gas analysis showed mild hypercapnia.?Conclusions?High frequency ventilation provided by anesthesia machine can be safely used in the rigid bronchoscopy procedure.