■需要气管内导管套囊的充气以提供通气。袖口压力应保持在适当范围内,以防止严重的气道并发症。本研究的目的是评估耳鼻咽喉科手术中气管导管套囊的压力变化。
这项单中心观察性研究于2020年4月至2020年11月在韩国Severance医院进行。纳入年龄>20岁计划接受耳鼻咽喉科外科手术的患者。计划进行气管造口术的患者和计划使用未翻盖气管内导管的患者被排除在外。全麻诱导后进行插管。将压力传感器连接到气管内导管的先导球囊,并连续监测袖带压力直至拔管。如果袖带压力不合适超过5分钟,通过注入或去除空气将其调整到适当的范围。计算袖带压力保持在适当范围内的时间百分比,并将其定义为治疗范围内的时间(TTR)。确定了袖带压力上升或下降的推测原因。
■在总共199名患者中,191例患者(96.0%)发生了超出适当范围的袖带压力改变.平均TTR为79.7%(标准差25.0%),头颈部手术的平均TTR最低,为69.0%,与耳鼻手术相比(94.2%和82.1%,分别)。68例患者(34.2%)在总麻醉时间的20%以上表现出气管导管袖带压力不足。26例患者(13.1%)在总麻醉时间的50%以下表现出最佳的气管导管袖带压力。导致不适当的袖带压力的原因被发现是不同的,包括位置变化,外科手术,解剖操作,和麻醉程序。
■在耳鼻咽喉手术中,由于各种因素,袖带压力升高或降低到适当范围之外。因此,我们建议在耳鼻喉手术麻醉期间密切连续监测袖带压.
■clinicaltrials.gov,标识符NCT03938493。
UNASSIGNED: Inflation of the endotracheal tube cuff is needed for providing ventilation. Cuff pressure should be maintained inside the appropriate range to prevent critical airway complications. The purpose of this study is to evaluate the pressure changes in the endotracheal tube cuff during otorhinolaryngologic surgery.
UNASSIGNED: This single-center observational study was conducted at Severance Hospital in Korea between April 2020 and November 2020. Patients aged >20 years scheduled to undergo otorhinolaryngological surgical procedures were enrolled. Patients undergoing planned tracheostomy and those who were slated for uncuffed endotracheal tube use were excluded. Intubation was performed after the induction of general anesthesia. A pressure transducer was connected to the pilot balloon of the endotracheal tube, and cuff pressure was continuously monitored until extubation. If the cuff pressure was not appropriate for more than 5 min, it was adjusted to the appropriate range by injecting or removing air. The percentage of time for which the cuff pressure remained within the appropriate range was calculated and defined as the time in the therapeutic range (TTR). The presumed cause for the rise or fall in cuff pressure was identified.
UNASSIGNED: In total 199 patients, alterations in cuff pressure outside the appropriate range occurred in 191 patients (96.0%). The mean TTR was 79.7% (SD 25.0%), and head and neck surgery had the lowest mean TTR of 69.0% compared to ear and nose surgeries (94.2 and 82.1%, respectively). Sixty-eight patients (34.2%) demonstrated inadequate endotracheal tube cuff pressure for more than 20% of the total anesthesia time. Twenty-six patients (13.1%) demonstrated optimal endotracheal tube cuff pressure for less than 50% of the total anesthesia time. The causative factors inducing inappropriate cuff pressure were found to vary, including positional changes, surgical procedure, anatomical manipulation, and anesthetic procedure.
UNASSIGNED: In otorhinolaryngologic surgery, cuff pressure increased or decreased outside the appropriate range due to various factors. Therefore, we suggest close continuous monitoring of cuff pressure during anesthesia for otorhinolaryngologic surgery.
UNASSIGNED: clinicaltrials.gov, identifier NCT03938493.