■半卧位(SRP)在麻醉出现期间减少术后低氧血症的功效尚不清楚,尽管其广泛使用。
■确定SRP和仰卧位患者术后低氧血症的差异。
■这项随机临床试验于2021年3月20日至2022年5月10日在中国一家三级医院进行。纳入计划在全身麻醉下进行腹腔镜上腹部手术的患者。研究招募和后续工作已完成。
■患者在手术结束时被随机分配到以下位置之一,直到离开麻醉后监护病房:仰卧位(S组),15°SRP(F组),或30°SRP(T组)。
■主要结果是麻醉后监护病房术后低氧血症的发生率。还评估了严重的低氧血症。
■700名患者(364名男性[52.0%];平均[SD]年龄,47.8[11.3]年),233人被随机分配到S组(126名男性[54.1%];平均[SD]年龄,48.2[10.9]年),233人F组(122名男性[52.4%];平均[SD]年龄,48.1[10.9]年),T组234人(118名女性[50.4%];平均[SD]年龄,47.2[12.1]年)。术后低氧血症在3组间差异显著(S组,233人中的109人[46.8%];F组,105/233[45.1%];T组,234人中有76人[32.5%];P=0.002)。T组与S组的差异具有统计学意义(风险比[RR],0.69[95%CI,0.55-0.87];P=0.002)和T组与F组(RR,0.72[95%CI,0.57-0.91];P=.007),但对于F组和S组(RR,0.96[95%CI,0.79-1.17];P=0.78)。严重低氧血症在3组间也有差异(S组,233人中的61人[26.2%];F组,233人中的53人[22.7%];T组,234人中的36人[15.4%];P=0.01)。T组与S组的差异有统计学意义(RR,0.59[95%CI,0.41-0.85];P=.005)。
■在这项腹腔镜上腹部手术患者麻醉恢复期间SRP的随机临床试验中,与F组和S组相比,T组术后低氧血症显著减少
■中国临床试验注册管理机构:ChiCTR2100045087.
UNASSIGNED: The efficacy of a semirecumbent position (SRP) in reducing postoperative hypoxemia during anesthesia emergence is unclear despite its widespread use.
UNASSIGNED: To determine the differences in postoperative hypoxemia between patients in an SRP and a supine position.
UNASSIGNED: This randomized clinical trial was performed at a tertiary hospital in China between March 20, 2021, and May 10, 2022. Patients scheduled to undergo laparoscopic upper abdominal surgery under general anesthesia were enrolled. Study recruitment and follow-up are complete.
UNASSIGNED: Patients were randomized to 1 of the following positions at the end of the operation until leaving the postanesthesia care unit: supine (group S), 15° SRP (group F), or 30° SRP (group T).
UNASSIGNED: The primary outcome was the incidence of postoperative hypoxemia in the postanesthesia care unit. Severe hypoxemia was also evaluated.
UNASSIGNED: Out of 700 patients (364 men [52.0%]; mean [SD] age, 47.8 [11.3] years), 233 were randomized to group S (126 men [54.1%]; mean [SD] age, 48.2 [10.9] years), 233 to group F (122 men [52.4%]; mean [SD] age, 48.1 [10.9] years), and 234 to group T (118 women [50.4%]; mean [SD] age, 47.2 [12.1] years). Postoperative hypoxemia differed significantly among the 3 groups (group S, 109 of 233 [46.8%]; group F, 105 of 233 [45.1%]; group T, 76 of 234 [32.5%]; P = .002). This difference was statistically significant for groups T vs S (risk ratio [RR], 0.69 [95% CI, 0.55-0.87]; P = .002) and groups T vs F (RR, 0.72 [95% CI, 0.57-0.91]; P = .007), but not for groups F vs S (RR, 0.96 [95% CI, 0.79-1.17]; P = .78). Severe hypoxemia also differed among the 3 groups (group S, 61 of 233 [26.2%]; group F, 53 of 233 [22.7%]; group T, 36 of 234 [15.4%]; P = .01). This difference was statistically significant for groups T vs S (RR, 0.59 [95% CI, 0.41-0.85]; P = .005).
UNASSIGNED: In this randomized clinical trial of SRP during anesthesia recovery in patients undergoing laparoscopic upper abdominal surgery, postoperative hypoxemia was significantly reduced in group T compared with group F or group S.
UNASSIGNED: Chinese Clinical Trial Registry Identifier: ChiCTR2100045087.