麻醉设备：改良的鼻咽通气道

本文由“小麻哥的日常"授权转载

摘要译文(供参考)

改良鼻咽氧疗在全麻下无通气氧合中的作用：

一项单中心随机对照临床研究

无通气氧合不仅对无法插管/通气的患者很重要，而且在计划保护气道时也可以常规使用。

我们的目的是比较接受改良鼻咽氧疗和在全身麻醉诱导后接受高流量经鼻氧疗法（HFNO）的患者的安全窒息时间。

这是一项单中心随机对照临床研究。

84名在全麻下接受择期腹腔镜妇科手术的女性患者被随机分为高流量经鼻氧疗组（HFNO组）或改良鼻咽氧疗组（Naso组）。

Kaplan-Meier生存曲线用于描述无通气氧合时间。

Naso组患者的安全窒息时间高于HFNO组患者（20（19.3-20.0）分钟Vs. 16.5（12.9-20）分钟，P<0.05）。

Naso组SpO2<95%的发生率低于HFNO组；

危险比0.3（95%置信区间0.2-0.6，P<0.0001）。

改良鼻咽氧疗法使用的氧气远远少于HFNO，是一种对正常女性患者进行无通气氧合的方便有效的方法。

图1使用氧气导管改良鼻咽气道。

图2 CONSORT流程图。

图3（A）SpO2患者比例 ≥ 20分钟窒息期间95%（HR 0.3，95%CI 0.2至0.6，P < 0.001). （B） 两组之间的安全窒息时间，水平线 = 中值的Naso组患者的安全窒息时间高于HFNO组患者[20（19.3-20.0）vs 16.5（12.9-20）min，P < 0.05].

图4两组间最低SpO2水平线 = 中值的Naso组患者的最低SpO2高于HFNO组患者[100%（93%-100%）vs.93%（92%-96%），P < 0.05].

图5两组机械通气后的第一个PetCO2，水平线 = 意思是Naso组高于HFNO组（60.9 ± 8.5对62.0 ± 6.6毫米汞柱，P < 0.001). 原文摘要 Role of modified nasopharyngeal oxygen therapy in apnoeic oxygenation under general anaesthesia: a single-centre, randomized controlled clinical study Apnoeic oxygenation is not only important for patients who cannot be intubated/ventilated, but also can be routinely employed when planning to secure the airway.We aimed to compare safe apnoea times between patients receiving modified nasopharyngeal oxygen therapy and those receiving high-flow nasal oxygen therapy (HFNO) following the induction of general anaesthesia.This was a single-centre, randomized controlled clinical study. Eighty-four female patients undergoing elective laparoscopic gynaecological surgery under general anaesthesia were randomly assigned to the high-flow nasal oxygen therapy group (Group HFNO) or the modified nasopharyngeal oxygen therapy group (Group Naso). A Kaplan-Meier survival curve was used to describe the apnoeic oxygenation time.The safe apnoea time of the patients in the Group Naso was higher than that of the patients in the Group HFNO (20 (19.3 to 20.0) vs. 16.5 (12.9 to 20) minutes, P < 0.05). The incidence of SpO2 < 95% in the Group Naso was lower than that in the Group HFNO; hazard ratio 0.3 (95% confidence interval 0.2 to 0.6, P < 0.0001). Modified nasopharyngeal oxygen therapy which uses far less oxygen than HFNO is a convenient and effective method of apnoeic oxygenation in normal female patients. Figure 1 Modified nasopharyngeal airway with an oxygen catheter. Figure 2 CONSORT flow chart. Figure 3 (A) Proportion of patients with SpO2 ≥ 95% during 20 min apnoea (HR 0.3, 95% CI 0.2 to 0.6, P < 0.001). (B) Safe apnoea time between the two groups, horizontal line = median. The safe apnoea time of the patients in the Group Naso was higher than that of the patients in the Group HFNO [20 (19.3 to 20.0) vs. 16.5 (12.9 to 20) min, P < 0.05]. Figure 4 The lowest SpO2 between the two groups, horizontal line = median. The lowest SpO2 of the patients in the Group Naso was higher than that of the patients in the Group HFNO [100% (93% to 100%) vs. 93% (92% to 96%), P < 0.05]. Figure 5 The first PetCO2 after mechanical ventilation between the two groups, horizontal line = mean. Group Naso was higher than that in the Group HFNO(60.9 ± 8.5 vs. 62.0 ± 6.6 mmHg, P < 0.001).

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