关键词: 面罩, 双水平气道正压, 无创通气, 腹腔镜胆囊切除手术, 全身麻醉

Abstract: 【Abstract】〓Objective〓To investigate the feasibility and safety of mask bi-level positive airway pressure (BiPAP) non-invasive ventilation in the laparoscopic cholecystectomy under general anesthesia. Methods〓Forty cases of laparoscopic cholecystectomy were randomly enrolled into mask BiPAP ventilation group (group I) and endotracheal intubation intermittent positive pressure ventilation (IPPV) group (groupⅡ) with 20 patients in each group. Mean blood pressure (MAP), heart rate (HR), pulse oximetry (SpO2) and Narcotrend Index (NI) were monitored and recorded during operation at the time points as following: before anesthesia (T0), after induction of anesthesia (T1), after the mask or intubation (T2), mechanical ventilation post 5 minutes (T3), pneumoperitoneum post 5 minutes (T4), the end of surgery (T5), and after remove the mask or endotracheal tube (T6). Blood gas analysis was performed at T0, T3, T4, T5 to record PaO2, PaCO2 and PH values. Results〓MAP and HR in group I at time points T2 and T6 were lower than that in groupⅡ (P<0.05), while NI in group I at T1 point was higher than that in group Ⅱ (P<0.05). Meanwhile, MAP and HR at T2 and T6 point were significantly higher than those other time points in group Ⅱ(P<0.05), However, no difference was noted in group I. There was no significant difference in PaO2, PaCO2 or pH value at T0, T3, T4, T5 time points between the two groups. Conclusion〓BiPAP mask non-invasive ventilation in laparoscopic cholecystectomy under general anesthesia was safe and feasible through which the effective ventilation and stable dynamics can be maintained.

Key words: Mask, Bi-level positive airway pressure, Non-invasive ventilation, Laparoscopic cholecystectomy, General anesthesia