Effect Of Transnasal Humidified Rapid-insufflation Ventilatory Exchange On Gastric Dilatation And Postoperative Gastrointestinal Function During The Oxygenation Period Of Apnea Induced By General Anesthesia In Patients

ObjectiveTo investigate the effect of transnasal humidified rapid-insufflation ventilatory exchange（THRIVE）on gastric dilatation and postoperative gastrointestinal function in patients with laparoscopic cholecystectomy（LC）undergoing induction of general anesthesia。MethodsFrom the first Affiliated Hospital of Yangtze University from February to October2021,60 patients received LC under intravenous and inhalation combined with general anesthesia were selected.According to the different ventilation strategies during the anesthesia induction period,SPSS software was used to randomly divide them into the THRIVE group（group T）and the closed mask ventilation group（group M）,with 30patients in each group.After the concentration of exhaled oxygen reached 90%,group T received THRIVE,group M received pressurized ventilation with a closed mask,and general anesthesia was induced.General data of the patients were recorded,cross-sectional gastric antral area measurements by ultrasonography,at the concentration of exhaled oxygen reached 90%（T₁）when oxygen was given,at the moment that tracheal intubation successful（T₂）.perioperation gastric dilation under video laparoscopy,perioperative medication and infusion,postoperative nausea and vomiting（PONV）,and postoperative gastrointestinal function were observed.ResultsFrom induction of anesthesia to successful endotracheal intubation,both groups ensure adequate oxygen supply,and Sp O₂>90%.At T₂,the partial pressure of end-tidal carbon dioxide(P_ETCO₂)of the group T was larger than that of the group M[（35.73±2.89）mm Hg ratio（31.53±3.75）mm Hg],and the cross-sectional gastric antral area was smaller than that of group M[（4.56±0.90）cm² ratio（5.71±1.25）cm²]（P<0.001）.The degree of gastric dilation and PONV under video laparoscopic in group T was better than that in group M（degree of gastric dilation:28 cases of grade 1,2 cases of grade 2,0 cases of grade 3 and 0 cases of grade 4 in group T,16 cases of grade 1,8 cases of grade 2,5 cases of grade 3 and 1 case of grade 4 in group M）;PONV degree:none 27cases,mild 2 cases and moderate 1 case in group T,and none 19 cases,mild 10 cases and moderate 1 case in group M,（P<0.05）.ConclusionsTHRIVE can ensure the effective oxygenation of patients during the induction period of general anesthesia,reduce the occurrence of gastric dilatation and PONV,and does not affect the recovery of gastrointestinal function.