摘要
Abstract
Objective To evaluate the feasibility and safety of high - frequency low - tidal volume intermittent positive pressure ventilation with laryngeal mask in thoracoscopic surgery for palmar hyperhidrosis. Methods Fifty palmar hyperhidrosis patients were randomly divided into two groups ( n=25 ) before endoscopic thoracic sympathectomy: group D underwent single-lung ventilation through douhle - lumen tube , while group L underwent small - tidal volume high - frequency intermittent positive pressure ventilation through laryngeal mask ( LMA ). Continuous monitoring of end - tidal carbon dioxide ( PetCO2 ), SpO2 ,mean arterial pressure ( MAP ), heart rate ( HR ), ECG and hand temperature perioperatively. Blood samples were collected for blood gas analysis at the following time points: before induction of anesthesia ( T1), before LMA/double - lumen tube placement ( T2 ), 1 minute after LMA/double-lumen tube placement ( T3 ), the moment of incision in the right chest ( T4 ), the moment of cutting off the right thoracic sympathetic nerve ( T5 ), after suture of the right incision ( T6 ), the moment of cutting off the left thoracic sympathetic nerve ( T7 ), after the suture of the left incision ( T8 ), removal of laryngeal mask / double - lumen tube ( T9 ); PetCO2, SpO2 , mean arterial pressure ( MAP ), and heart rate (HR) were also recorded. Intubation time of LMA/double -lumen tube, length of anesthesia time, perioperative and postoperative complications and side effects, and dosage of anesthetics were also recorded. Results Intubation time and length of anesthesia time were significantly shorter in group L than in group D ( P＜0.05 ). Dosages of propofol and sufentanil were significantly lower in group L than in group D ( P ＜ 0.05 ).The anesthesia process and the surgery were successful in both groups, with no vomiting, regurgitation, aspiration, and postoperative hoarseness observed. Compared with the group D, incidence rates of post - extubation cough and postoperative sore throat were significantly lower in group L ( P＜0.05 ). MAP and HR levels at T3 , and T9 were significantly higher than at T1 and T2 in group D than in group L ( P＜0.05 ). and were significantly higher than T3 , and T9 than in group L ( P＜0.05 ). PaCO2 increased in hoth groups during the thoracoscopic operation at T5 and T7 ( P＜0.05 ). Conclusion High - frequency low - tidal volume intermittent positive pressure ventilation with laryngeal mask is applicable to anesthesia in thoracoscopic surgery for palmar hyperhidrosis.关键词
胸腔镜/麻醉/喉罩/小潮气量间歇正压通气/手汗症Key words
Thoracoscopes/ Aanesthesia/ Laryngeal mask/ Intermittent positive - pressure ventilation with low tidal volume / Palmar hyperhidrosis分类
医药卫生
