科研之友
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摘要
Study objective: To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia. Design: Prospective, randomized study. Setting: University-affiliated hospital. Patients: Six male subjects were included in the present study. Intervention: We used pressure-flow relationships to evaluate critical closing pressure (Paul-) and upper airway resistance in different conditions of body and head position. Anesthesia was induced and maintained with a propofol infusion, targeting a constant blood concentration of 1.5 to 2.0 mu g/mL to establish an adequate depth of anesthesia, with patients breathing spontaneously through a nasal mask. An air-inflatable pneumatic actuator was used to achieve jaw closure. Nasal mask pressure was intermittently reduced to evaluate upper airway collapsibility (passive P-CRIT) and upstream resistance under 4 different conditions: (1) neutral occlusion at 0-cm head elevation (baseline), (2) jaw closure at 0-cm head elevation, (3) neutral occlusion at 6-cm head elevation, and (4) jaw closure at 6-cm head elevation. Pour and upstream resistance under each condition were compared using 1-way analysis of variance. P < .05 was considered significant. Measurements: The pressure and inspiratory flow at the subjects' nose mask were recorded. Polysomonographic parameters (electroencephalograms, electrooculograms, submental electromyograms, and plethysmogram) were also recorded. Main results: The combination of 6-cm head elevation with jaw closure using the pneumatic actuator decreased upper airway collapsibility (P-CRIT approximate to -3.0 cm H2O) compared to the baseline position (P-CRIT approximate to -1.2 cm H2O; P = .0003). Conclusion: We demonstrated that jaw closure using an air-inflatable pneumatic actuator device can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia.
- 出版日期2016-3
