Clinical Observation Of Endotracheal Tube Movement Undergoing Gynecological Laparoscopic Surgery With Trendelenburg Position

Objective:This study aims to observe the length between the tip of tracheal tube and carina(L_ab)and the change of airway pressure（Paw）and to explore methods of preventing accidental bronchial intubation undergoing gynecological laparoscopic surgery with the Trendelenburg position（15o）.Methods:A total of fifty ASAⅠorⅡfemale patients aged 18-65 years undergoing elective gynecological laparoscopic surgery in the first hospital of Jilin university from March 2017 to August 2017 were enrolled in this study.L_abb and Paw were observed at the different times:5min after endotracheal intubation（T₀）,Immediately after CO₂ pneumo-peritoneum combined with the Trendelenburg position（T₁）,5 min after CO₂ pneumoperitoneum combined with the Trendelenburg position（T₂）,10 min after CO₂ pneumoperitoneum combined with the Trendel-enburg position（T₃）,15 min after CO₂ pneumoperitoneum combined with the Trendelenburg position（T₄）,20 min after CO₂ pneumoperitoneum combined with the Trendelenburg position（T₅）,25 min after CO₂ pneum-operitoneum combined with the Trendelenburg position（T₆）,and 30 min after CO₂ pneumoperitoneum combined with the Trendelenburg position（T₇）.Results:Compared with the time point of T₀,L_abb was significantly shorter and Paw significantly increased at T₁-T₇（P<0.05）.Compared with the previous time point,L_abb shortened significantly at T₁-T₄ and Paw was increased obviously at T₁-T₃（P<0.05）.L_abdecreased significantly by（0.99±0.23）cm and the maximum change in L_abb was 1.60 cm after CO₂pneumoperitoneum combined with the Trendelenburg position（15o）.Conclusions:In the gynecological laparoscopic surgery,L_abb was significantly shorter,which shortened gradually and then stabilized after 15 minutes,and Paw was obviously increased,which increased gradually and then stabilized after 10 minutes,after CO₂ pneumoperitoneum combined with the Trendelenburg position（15o）.The method of marking the position of intratracheal intubation is effective and it can be used to prevent accidental bronchial intubation undergoing gynecological laparoscopic surgery with Trendelenburg position.