[1]蔡 俊,闵昱源.THRIVE技术用于单人无面罩全麻诱导对患者脑氧变化及术后认知功能的影响[J].医学信息,2025,38(05):132-135.[doi:10.3969/j.issn.1006-1959.2025.05.022]
 CAI Jun,MIN Yuyuan.Effect of THRIVE Technique on Cerebral Oxygen Change and Postoperative Cognitive Function in Patients with General Anesthesia Without Mask Induction by Single Person[J].Journal of Medical Information,2025,38(05):132-135.[doi:10.3969/j.issn.1006-1959.2025.05.022]
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THRIVE技术用于单人无面罩全麻诱导对患者脑氧变化及术后认知功能的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年05期
页码:
132-135
栏目:
论著
出版日期:
2025-03-01

文章信息/Info

Title:
Effect of THRIVE Technique on Cerebral Oxygen Change and Postoperative Cognitive Function in Patients with General Anesthesia Without Mask Induction by Single Person
文章编号:
1006-1959(2025)05-0132-04
作者:
蔡 俊1闵昱源2
1.宝鸡市中心医院麻醉手术科二科,陕西 宝鸡 721000;2.西安市人民医院/西安市第四医院麻醉与围手术期医学中心,陕西 西安 710000
Author(s):
CAI Jun1 MIN Yuyuan2
1.The Second Department of Anesthesiology and Surgery, Baoji Central Hospital, Baoji 721000, Shaanxi, China;2.Anesthesia and Perioperative Medical Center of Xi′an People′s Hospital/Xi′an Fourth Hospital, Xi′an 710000, Shaanxi, China
关键词:
单人无面罩全麻诱导脑氧变化认知功能THRIVE技术
Keywords:
General anesthesia without mask induction by single person Cerebral oxygen changes Cognitive function THRIVE technology
分类号:
R614.2
DOI:
10.3969/j.issn.1006-1959.2025.05.022
文献标志码:
A
摘要:
目的 探究THRIVE技术用于单人无面罩全麻诱导对患者脑氧变化及术后认知功能的影响。方法 选取2021年10月-2022年10月于宝鸡市中心医院全身麻醉下实施手术的患者90例,采用随机数字表法分为HFNO组、NOT组、THRIVE组,每组30例。HFNO组使用加压面罩进行预充氧,NOT组使用一次性普通吸氧面罩进行预充氧,THRIVE组使用OptiFlowTM高流量经鼻导管对患者进行3 min预充氧。INIRS监测局部脑氧饱和度(rScO2),应用MMSE、连线测试及凹槽拼板测试评估患者术前及术后24 h的认知功能变化。结果 三组经预充氧后rScO2均较入室后提升,全麻诱导后rScO2均较预充氧后下降,差异有统计学意义(P<0.05);术中各组患者均未出现rScO2<55%现象。三组术毕及手术苏醒后rScO2比较,差异无统计学意义(P>0.05)。HFNO组与NOT组不同时期rScO2比较,差异无统计学意义(P>0.05)。THRIVE组麻醉诱导后rScO2高于NOT组,差异有统计学意义(P<0.05),术毕及苏醒后rScO2比较,差异无统计学意义(P>0.05)。三组手术前及术后各时段MMSE评分及认知障碍发生率比较,差异均无统计学意义(P>0.05)。三组术前及术后24 h连线测试和凹槽拼版测试时间比较,差异均无统计学意义(P>0.05)。结论 THRIVE技术用于单人无面罩全麻诱导,能降低麻醉诱导对脑氧的影响,且未见明显术后认知障碍。
Abstract:
Objective To explore the effect of THRIVE technique on cerebral oxygen changes and postoperative cognitive function in patients with general anesthesia without mask induction by single person. Methods A total of 90 patients who underwent surgery under general anesthesia in Baoji Central Hospital from October 2021 to October 2022 were selected and divided into HFNO group, NOT group and THRIVE group by random number table method, with 30 patients in each group. The HFNO group was pre-oxygenated using a pressurized mask, the NOT group was pre-oxygenated using a disposable ordinary oxygen mask, and the THRIVE group was pre-oxygenated for 3 minutes using an OptiFlowTM high-flow nasal catheter. Regional cerebral oxygen saturation (rScO2) was monitored by INIRS. The changes of cognitive function before and 24 hours after operation were evaluated by MMSE, connection test and groove plate test. Results The rScO2 of the three groups after pre-oxygenation was higher than that after entering the room, and the rScO2 after induction of general anesthesia was lower than that after pre-oxygenation, the difference was statistically significant (P<0.05); there was no phenomenon of rScO2<55% in each group during the operation, and there was no significant difference in rScO2 between the three groups after operation and after recovery (P>0.05). There was no significant difference in rScO2 between HFNO group and NOT group in different periods (P>0.05). The rScO2 after anesthesia induction in the THRIVE group was higher than that in the NOT group, and the difference was statistically significant (P<0.05), but there was no significant difference in rScO2 between the two groups after operation and after recovery (P>0.05). There was no significant difference in MMSE score and incidence of cognitive impairment among the three groups before and after operation (P>0.05). There was no significant difference in the time of connection test and groove puzzle test among the three groups before and 24 h after operation (P>0.05). Conclusion THRIVE technology can reduce the effect of anesthesia induction on cerebral oxygen during general anesthesia without mask induction by single person, and there is no obvious postoperative cognitive impairment.

参考文献/References:

[1]Wimalasena Y,Burns B,Reid C,et al.Apneic oxygenation was associated with decreased desaturation rates during rapid sequence intubation by an Australian helicopter emergency medicine service[J].Ann Emerg Med,2015,65(4):371-376.[2]Gustafsson IM,Lodenius A,Tunelli J,et al.Apnoeic oxygenation in adults under general anaesthesia using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) - a physiological study[J].Br J Anaesth,2017,118(4):610-617.[3]Mir F,Patel A,Iqbal R,et al.A randomised controlled trial comparing transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation with facemask pre-oxygenation in patients undergoing rapid sequence induction of anaesthesia[J].Anaesthesia,2017,72(4):439-443.[4]Salazar F,Do?觡ate M,Boget T,et al.Relationship between intraoperative regionalcerebral oxygen saturation trends and cognitive decline after total knee replacement:apost-hocanalysis[J].BMC Anesthesiol,2014,14:58.[5]侯瑜,王子轩,聂丽霞,等.压力支持通气联合低吸入氧浓度对行机器人辅助前列腺癌根治术的老年患者全麻苏醒期肺不张的影响[J].中华老年医学杂志,2023,42(12):1447-1452.[6]Patel A,Nouraei SA.Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways[J].Anaesthesia,2015,70(3):323-329.[7]胡正芳,王娟,菅敏钰,等.术中吸氧浓度对行脑血管再通术患者术后神经功能和并发症的影响[J].首都医科大学学报,2023,44(5):865-871.[8]林旭,刘华强,郭雨微,等.不同吸入氧浓度对腹腔镜手术老年患者术后谵妄的影响:大样本、前瞻性、随机、双盲研究[J].中华麻醉学杂志,2020,40(10):1188-1191.[9]王晶,唐娜.经鼻高流量氧疗在老年慢性阻塞性肺疾病急性加重期伴Ⅱ型呼吸衰竭患者中的应用[J].中国临床研究,2024,37(2):242-245.[10]陈美贤,陆福鼎,廖朝霞,等.接受手术治疗的OSAS患者麻醉诱导期间经鼻湿化快速喷射通气交换技术的应用观察[J].山东医药,2021,61(3):66-68.[11]胡静,尹加林,曹媛媛,等.经鼻湿化快速充气交换通气技术在颈椎骨折患者经鼻清醒气管插管中的应用[J].临床麻醉学杂志,2022,38(7):698-702.[12]徐亚杰,鲍红光,史宏伟,等.经鼻湿化快速充气通气交换技术在住院医师规范化培训纤维支气管镜引导气管插管中的应用[J].临床麻醉学杂志,2023,39(7):741-744.[13]重庆市中西医结合学会麻醉学专委会.经鼻湿化高流量通气技术在围手术期气道管理中应用的重庆专家共识[J].重庆医学,2023,52(14):2081-2088,2100.[14]Ng I,Krieser R,Mezzavia P,et al.The use of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) for pre-oxygenation in neurosurgical patients: a randomised controlled trial[J].Anaesth Intensive Care,2018,46(4):360-367.[15]Rudlof B,Hohenhorst W.Use of apneic oxygenation for the performance of pan-endoscopy[J].Otolaryngol Head Neck Surg,2013,149(2):235-239.[16]历洋,刘真,华震.经鼻高流量加温加湿快速给氧装置的临床应用[J].国际麻醉学与复苏杂志,2020,41(6):604-608.[17]沈妍,赵倩,方兆晶,等.快充式经鼻湿化高流量通气在双腔支气管插管中的应用[J].江苏医药,2021,47(10):1039-1042.[18]耿晓娟,袁林芳.经鼻导管高流量吸氧对体外循环术后患者认知功能的影响[J].中国处方药,2018,16(12):7-10.

更新日期/Last Update: 1900-01-01