Comparison of efficacy of pressure-controlled ventilation and volume-controlled ventilation in patients undergoing lumbar surgery in prone position
10.3760/cma.j.issn.0254-1416.2013.11.021
- VernacularTitle:俯卧位腰椎手术患者压力控制通气和容量控制通气效果的比较
- Author:
Ling ZHOU
;
Juan LI
;
Xiaoqing CHAI
- Publication Type:Journal Article
- Keywords:
Respiration,artificial;
Prone position
- From:
Chinese Journal of Anesthesiology
2013;33(11):1365-1367
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in patients undergoing lumbar surgery in prone position.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 45-90 kg,scheduled for lumbar surgery in prone position,were randomly divided into 2 groups (n =30 each) using a random number table:pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V).Anesthesia was induced with dexamethasone 10 mg,etomidate 0.3 mg/kg,sufentanil 0.4 μg/kg,and rocuronium 0.6 mg/kg and maintained with propofol 2-4 mg· kg-1 · h-1,remifentanil 6-10 μg· kg-1 · h-1 and vecuronium 0.08 mg· kg-1 · h-1.The i-gel laryngeal mask airways were inserted after induction and the patients were mechanically ventilated.A gastric tube was inserted through the drain tube of i-gel.The maximum inspiratory pressure was adjusted to reach the tidal volume (VT) of 8 ml/kg in group P and the VT was set at 8 ml/kg in group V.PTrCO2 was maintained at 30-40 mm Hg.The mean airway pressure (Pmean) and peak airway pressure (Peak) were recorded immediately after insertion of i-geal (T0),immediately after the patients were turned to prone position (T1),immediately before skin incision (T2),30 min after the beginning of surgery (T3),immediately after the end of surgery (T4) and immediately after the patients were turned to supine position (T5).While dynamic lung compliance (Cdyn) was calculated.Arterial blood samples were taken at the same time points for blood gas analysis.Oxygenation index (OI) and respiratory index (RI) were calculated.Results Compared with group V,Pmoan and Ppeak were significantly decreased at T0-5,Cdyn and OI were increased,and RI was decreased at T1-4 in group P (P ＜ 0.05).Conclusion Compared with volumecontrolled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy and reduce prone position-induced effect on respiratory function in patients undergoing lumbar surgery.
