全麻诱导中假牙对面罩通气效果的影响
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背景：无牙患者在麻醉和手术前需要取出假牙，但其时机尚不清楚。
方法：本试验通过前瞻、随机、对照研究评估全麻诱导时面罩通气期间去除假牙的效果。166名患者随机分成两组，假牙组为麻醉诱导后面罩通气期间保留假牙在原位，非假牙组则在面罩通气期间去除假牙。麻醉科医生对面罩通气的效果进行评估。
结果：面罩通气成功标准是在3L/min的新鲜气流量给氧及控制压力阀压力在20 cm H2O情况下，PETCO2增加20mmHg并能降低至基础水平。结果假牙组84名患者中有61名（73%）通气良好，而非假牙组81名患者中只有40名（49%）通气良好（优势比0.37，95% CI = 0.19–0.70, P = 0.002）。
结论：无牙患者全身麻醉诱导过程中保留假牙在原位有助于面罩通气。
The Effect of Leaving Dentures in Place on Bag-Mask Ventilation at Induction of General Anesthesia
Niamh P. Conlon, FCARCSI*, Richard P. Sullivan, MBChB*, Peter G. Herbison, MSc*, Mathew Zacharias, PhD*, and Donal J. Buggy, MD
From the *Department of Anesthesia, Dunedin Hospital, Dunedin, New Zealand; Department of Anesthesia, Mater Misericordiae University Hospital, Dublin, Ireland; and Outcomes Research Institute, Cleveland Clinic, Cleveland, Ohio.
Address correspondence and reprint requests to Niamh Conlon, FCARCSI, Department of Anesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland. Address e-mail to tallniamh@hotmail.com.
Abstract
BACKGROUND: The optimum timing for denture removal in edentulous patients before anesthesia and surgery is uncertain.
METHODS: We conducted a prospective, randomized, controlled trial to evaluate the effect of leaving dentures in during bag-mask ventilation at induction of general anesthesia. One hundred sixty-six edentulous patients were randomized to two groups. The Dentures-In group was bag-mask ventilated after induction of anesthesia with dentures left in place. The Dentures-Out group patients had their dentures removed before bag-mask ventilation. The degree of difficulty of bag-mask ventilation was assessed by the anesthesiologist.
RESULTS: Successful bag-mask ventilation, as defined by a increase in ETco2 to 20 mm Hg and back to baseline with 3 L/min fresh gas flow and the adjustable pressure limiting valve at 20 cm H2O, was achieved in 61 of 84 (73%) of the Dentures-In patients compared with 40 of 81 (49%) of the Dentures-Out patients (odds ratio 0.37, 95% CI = 0.19–0.70, P = 0.002).
CONCLUSION: We conclude that bag-mask ventilation is easier in edentulate patients when their dentures are left in situ during induction of general anesthesia.
Anesth Analg 2007;105:370-373
假牙与气道通畅.pdf (173.55k)
http://www.anesthesia-analgesia.org/cgi/content/abstract/105/2/370
方法：本试验通过前瞻、随机、对照研究评估全麻诱导时面罩通气期间去除假牙的效果。166名患者随机分成两组，假牙组为麻醉诱导后面罩通气期间保留假牙在原位，非假牙组则在面罩通气期间去除假牙。麻醉科医生对面罩通气的效果进行评估。
结果：面罩通气成功标准是在3L/min的新鲜气流量给氧及控制压力阀压力在20 cm H2O情况下，PETCO2增加20mmHg并能降低至基础水平。结果假牙组84名患者中有61名（73%）通气良好，而非假牙组81名患者中只有40名（49%）通气良好（优势比0.37，95% CI = 0.19–0.70, P = 0.002）。
结论：无牙患者全身麻醉诱导过程中保留假牙在原位有助于面罩通气。
The Effect of Leaving Dentures in Place on Bag-Mask Ventilation at Induction of General Anesthesia
Niamh P. Conlon, FCARCSI*, Richard P. Sullivan, MBChB*, Peter G. Herbison, MSc*, Mathew Zacharias, PhD*, and Donal J. Buggy, MD
From the *Department of Anesthesia, Dunedin Hospital, Dunedin, New Zealand; Department of Anesthesia, Mater Misericordiae University Hospital, Dublin, Ireland; and Outcomes Research Institute, Cleveland Clinic, Cleveland, Ohio.
Address correspondence and reprint requests to Niamh Conlon, FCARCSI, Department of Anesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland. Address e-mail to tallniamh@hotmail.com.
Abstract
BACKGROUND: The optimum timing for denture removal in edentulous patients before anesthesia and surgery is uncertain.
METHODS: We conducted a prospective, randomized, controlled trial to evaluate the effect of leaving dentures in during bag-mask ventilation at induction of general anesthesia. One hundred sixty-six edentulous patients were randomized to two groups. The Dentures-In group was bag-mask ventilated after induction of anesthesia with dentures left in place. The Dentures-Out group patients had their dentures removed before bag-mask ventilation. The degree of difficulty of bag-mask ventilation was assessed by the anesthesiologist.
RESULTS: Successful bag-mask ventilation, as defined by a increase in ETco2 to 20 mm Hg and back to baseline with 3 L/min fresh gas flow and the adjustable pressure limiting valve at 20 cm H2O, was achieved in 61 of 84 (73%) of the Dentures-In patients compared with 40 of 81 (49%) of the Dentures-Out patients (odds ratio 0.37, 95% CI = 0.19–0.70, P = 0.002).
CONCLUSION: We conclude that bag-mask ventilation is easier in edentulate patients when their dentures are left in situ during induction of general anesthesia.
Anesth Analg 2007;105:370-373
假牙与气道通畅.pdf (173.55k) http://www.anesthesia-analgesia.org/cgi/content/abstract/105/2/370
作者: 西门吹血编译
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