Feasibility of Prone Position Tracheal Intubation and Positive End-expiratory Pressure Ventilation in Elderly Patients with ERCP
Objective To explore the feasibility of prone position tracheal intubation in elderly patients undergoing endoscopic retrograde cholangiopancreatography(ERCP)and the protective effect of positive end expiratory pressure ventilation on the lungs.Methods A total of 560 elderly patients undergoing ERCP surgery were selected and divided into an observation group and control group using a random number table method,with 280 cases in each group.The observation group was prone on the left side,and anesthesia induction and endotracheal intubation were performed after positioning.The control group underwent endotracheal intubation after anesthesia induction in the supine position,and was adjusted to the left prone position after the intubation completed.After induction of general anesthesia,a tracheal catheter was inserted under a visual laryngoscope and mechanical ventilation was performed.The degree of opening,intubation time,success rate of intubation,intubation injury,complications in postural position and surgical time,as well as the mean arterial pressure(MAP),heart rate(HR)and end tidal carbon dioxide partial pressure(PETCO2)before induction,during tracheal intubation,during postural position,during and after surgery were recorded.Pulmonary complications such as atelectasis and pneumothorax were analyzed by digital X-ray.Results There were no differences in terms of mouth opening,intubation time,intubation success rate,intubation injury,surgical time,pulmonary complications,and MAP,HP,and PETCO2 before induction,during tracheal intubation,during surgery,and after surgery between the observation group and the control group(P＞0.05).The observation group had smaller fluctuations in MAP and lower incidence of complications in postural position(P＜0.05).Conclusion Tracheal intubation in prone position is feasible for elderly patients with ERCP,with fewer complications.The positive end expiratory pressure ventilation mode has a certain lung protective effect on elderly patients.
prone positiontracheal intubationpositive end expiratory pressure ventilationelderly patient
万方数据
维普
