目的:建立一种简单有效模拟面罩通气困难(DMV)的临床试验方法.方法:纳入无DMV指征的全麻患者40例.麻醉诱导后,分别实施普通面罩通气方法(双手VE面罩通气方法)和模拟DMV方法(单手面罩直接加压法)进行面罩通气.主要观察指标为是否成功实施面罩通气;次要观察指标为实际潮气量、气道峰压、呼气末二氧化碳分压(PETCO2).结果:35例(87.5％)患者通过单手面罩直接加压法可以成功模拟DMV.单手面罩直接加压法患者潮气量[143.5(104.8,174.3)mL]较双手 VE 面罩通气方法[442.0(409.3,482.8)mL]下降,气道峰压升高[31.0(27.0,37.0)cmH2O vs.13.0(10.3,14.0)cmH2O],PETCO2 降低[1.5(0,7.0)mmHg vs.32.5(30.0,35.0)mmHg](P＜0.001).结论:单手面罩直接加压法可有效模拟 DMV.
Investigation on the feasibility of applying one-handed direct pressure to simulating difficult mask ventilation
Objective:To establish a simple and effective clinical trial method for difficult mask ventilation(DMV).Methods:Forty patients under general anesthesia with no difficulty facemask ventilation indicator were included.After anesthesia induction,the normal face mask ventilation method(two-handed VE facemask ventilation)and the simulated difficult mask ventilation method(one-handed direct pressure mask ventilation)were implemented for face mask ventilation.The primary outcomes were defined as successful or failed mask ventilation,and the secondary outcomes consisted of actual tidal volume,peak airway pressure,and end tidal carbon dioxide partial pressure.Results:Difficult mask ventilation was successfully simulated by one-handed direct pressure approach in 35 of the 40 patients(87.5％).Compared to two-handed VE facemask ventilation method,the tidal volume was significantly decreased[442.0(409.3,482.8)vs.143.5(104.8,174.3)mL,P＜0.001],while the peak airway pressure was notably increased[13.0(10.3,14.0)vs.31.0(27.0,37.0)cmH2O,P＜0.001],and the end tidal carbon dioxide partial pressure was markedly dropped[32.5(30.0,35.0)vs.1.5(0,7.0)mmHg,P＜0.001]under the one-handed direct pressure mask ventilation.Conclusion:The one-handed direct pressure mask ventilation method can effectively simulate difficult mask ventilation.
mask ventilationdifficult airwayone-handed direct pressure mask ventilation methodairway management
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