| Purpose:This project aims to observe the optimal end expiratory carbon dioxide partial pressure(PETCO250)and discuss median effective dose of PETCO250 when extracting enhanced laryngeal mask satisfactorily.(No airway responsiveness like biting tube,cough,breath holding,body movement,hypoxemia and laryngospasm etc.)The results provides clinical basis for extraction timing of laryngeal mask.Methods:35 children(3-5 years old and systemic ASA score wasⅠ～Ⅱ)who had ophthalmology Strabismus and trichiasis corrective procedure in general anesthesia are collected.And 30 of them are finally studied in this project because other 5 withdraw.These 30 children all had ophthalmology surgery in general anesthesia which enhanced laryngeal mask was used.According to the methods of sequential test,laryngeal mask was extracted in different PETCO2 value successively.And the initial PETCO2 is acquired in the pre-experiment of first child when removing the mask.The next child’s PETCO2 is decided by satisfaction of the previous one.If dissatisfied,PETC02 for next kid rises ImmHg and on the contrary declines ImmHg until the end of all experiments.These children’s information is recorded including general materials,occurrence of respiratory tract complication,residual of muscle relaxation depth of anesthesia and changes of blood heology when removing the laryngeal mask.Results:(1)30 children are ultimately studied in the project including 14 males and 16 females,their age range is(53.93±10.305)month,height(106.47±6.986)cm,weight(18.350±3,4068)kg,BMI(16.052±1.4659)kg/m2,duration of surgery(49.43±13.536)min,duration of anesthesia(59.73±13.906)min,recovery time of autonomous respiration(4.10±1.709)min,time of extracting laryngeal mask(10.27±4.017)min,time of wake(17.43±4.216)min;(2)Value of PETCO250 calculating through Dixon-Massey Sequential test formula which satisfied 50%of the children is 51.0858 mmHg and its 95%confidence interval(CI)is(50.3215,51.8617);(3)NTS is C1-D1 and NTI is 54-72 monitoring by Narcotrend when removing the laryngeal mask.And 7 of the children had bucking,3 holding breath,11 limbs movement and 11 biting tube as well.No hypoxemia,laryngospasm or muscle relaxation were observed,The Narcotrend Index of the dissatisfied laryngeal mask group and the satisfactory laryngeal mask airway group respectively were 63.8 + 2.808 and 60.87 + 3.182,with statistically significant difference;(4)The changes in hemodynamics of all children:the changes of respiration,heart rate,mean arterial pressure and blood oxygen saturation at all time points were not more than 20%of the basic value.Conclusion:(1)Under the anesthetic scheme of this study,PETCO250 which satisfied 50%of the children is 51.0858 mmHg when moving the laryngeal mask after the pediatric ophthalmology surgery and its 95%confidence interval(CI)is(50.3215,51.8617),When the PETCO2 is 52-53 mmHg,the incidence of respiratory complications is relatively low.(2)The Narcotrend Index was 60.87 + 3.182 when the laryngeal mask was removed satisfactorily,The depth of anesthesia is more deep than that of dissatisfaction.(3)No airway obstruction was found in all cases,such as glossoptosis when moving the tube under deep anesthesia or deep sedation,The suitable time for laryngeal mask extraction of thePETC02 is 52-53 mmHg and NTI is 60.87 + 3.182.(4)In this study,children hemodynamics was basically stable. |
PDF Full Text Request