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

摘要：

【摘要】〓目的〓探讨面罩双水平气道正压(BiPAP)无创通气在腹腔镜胆囊切除手术全身麻醉中应用的安全可行性。方法〓40例行腹腔镜胆囊切除手术的患者,随机分为面罩BiPAP通气组(I组)和气管内插管间歇正压通气(IPPV)组(Ⅱ组),每组20例,术中监测平均动脉血压(MAP)、心率(HR)、脉搏血氧饱和度(SpO₂)以及Narcotrend指数(NI),并在麻醉前(T0)、麻醉诱导后(T₁)、插管或上面罩后(T₂)、机械通气后5 min(T₃)、气腹后5 min(T₄)、手术结束(T₅)、拔管或去面罩后(T₆)时点记录其数值;两组患者在T₀、T₃、T₄、T₅时点做血气分析,记录PaO₂、PaCO₂、pH值。结果〓I组MAP、HR在T₂和T₆时点低于Ⅱ组(P<0.05),而I组NI在T₁时点高于Ⅱ组(P<0.05);组内比较Ⅱ组在T₂、T₆时点MAP、HR显著升高(P<0.05),而I组在这两个时点无变化。PaO₂、PaCO₂、pH值在T₀、T₃、T₄、T₅时点组间比较差异均无统计学意义。结论〓面罩BiPAP无创通气应用于腹腔镜胆囊切除手术全身麻醉能够进行有效通气,且能维持患者血流动力学平稳,是一种安全有效的通气方式。

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