Laryngeal and respiratory responses to tracheal irritation at different depths of enflurane anesthesia in humans.
Laryngeal and respiratory responses to tracheal irritation at different depths of enflurane anesthesia in humans.
复制标题
人类安氟烷麻醉不同深度时喉部和呼吸系统对气管刺激的反应。
DOI：
10.1097/00000542-199007000-00008
复制
发表时间：
1990
期刊：
影响因子：
8.8
通讯作者：
N. Yokokawa
中科院分区：
文献类型：
--
作者：
T. Nishino;K. Hiraga;N. Yokokawa
研究了三种不同深度的安氟醚麻醉（1.0、1.4和1.8 MAC）对9例插入双气囊气管内导管的女性患者气管滴注蒸馏水时喉部和呼吸反应的影响。通过测量位于喉部内的盐水填充袖带中的压力来监测喉部反应，并且通过测量呼吸流量和气管气道压力来监测呼吸反应。在1.0 MAC、1.4 MAC和1.8 MAC下，响应气管刺激的喉套囊压力增加分别为19.7 +/- 4.5 cmH 2 O（平均值+/- SD）、13.9 +/- 3.6 cmH 2 O和7.6 +/- 1.8 cmH 2 O（麻醉剂量P <0.01）。在1.0 MAC的安氟醚麻醉下，气管滴注生理盐水引起立即喉收缩和气管反应的所有组成部分，如呼吸暂停、呼气反射、咳嗽反射和痉挛性喘息。在1.4和1.8 MAC时，相同的刺激在大多数患者中仅引起呼吸暂停和喉部收缩。这些结果表明，麻醉深度的变化可以改变喉和呼吸反应气管刺激。喉和呼吸反应的密切联系可能是防御反射协同作用的一个组成部分。
The effect of three different depths of enflurane anesthesia (1.0, 1.4, and 1.8 MAC) upon laryngeal and respiratory responses to tracheal instillation of distilled water in nine female patients in whom a double-cuffed endotracheal tube had been inserted was investigated. The laryngeal responses were monitored by measuring the pressure in the saline-filled cuff positioned within the larynx, and the respiratory responses were monitored by measuring ventilatory flow and tracheal airway pressure. Increases in laryngeal cuff pressure in response to tracheal irritation were 19.7 +/- 4.5 cmH2O (mean +/- SD) at 1.0 MAC, 13.9 +/- 3.6 cmH2O at 1.4 MAC, and 7.6 +/- 1.8 cmH2O at 1.8 MAC, respectively (P less than 0.01 for anesthetic dose). At 1.0 MAC of enflurane anesthesia, tracheal instillation of saline caused immediate laryngeal constriction and all components of the tracheal response, such as apnea, expiration reflex, cough reflex, and spasmodic panting. At 1.4 and 1.8 MAC, the same stimulation caused only apnea and constriction of the larynx in the majority of patients. These results indicate that changes in depth of anesthesia can modify the laryngeal and respiratory responses to tracheal irritation. The close association of laryngeal and respiratory responses may be an integral part of the defensive reflex synergism.