文献进展摘要及翻译贵州医科大学麻醉学系研究生心电生理及记忆.PDF

文献进展摘要及翻译 贵州医科大学麻醉学系研究生（心电生理及记忆课题组） 文献名：（中文）健康志愿者异丙酚和七氟醚麻醉深度对上气道塌 陷、呼吸颏舌肌的活化和呼吸的影响 （英文）Effects of Depth of Propofol and Sevoflurane Anesthesia on Upper Airway Collapsibility, Respiratory Genioglossus Activation, and Breathing in Healthy Volunteers 译 者：张凯强 原文摘要：Abstract Background:Volatile anesthetics and propofol impair upper airway stability and possibly respiratory upper airway dilator muscle activity. The magnitudes of these effects have not been compared at equivalent anesthetic doses. We hypothesized that upper airway closing pressure is less negative and genioglossus activity is lower during deep compared with shallow anesthesia. Methods:In a randomized controlled crossover study of 12 volunteers, anesthesia with propofol or sevoflurane was titrated using a pain stimulus to identify the threshold for suppression of motor response to electrical stimulation. Measurements included bispectral index, genioglossus electromyography, ventilation, hypopharyngeal pressure, upper airway closing pressure, and change in end-expiratory lung volume during mask pressure drops. Results:A total of 393 attempted breaths during occlusion maneuvers were analyzed. Upper airway closing pressure was significantly less negative at deep versus shallow anesthesia (−10.8 ± 4.5 vs. − .3 ± 4.4 cm H O, respectively [mean ± SD]) and correlated with the bispectral index 2 (P 0.001), indicating a more collapsible airway at deep anesthesia. Respiratory genioglossus activity during airway occlusion was significantly lower at deep compared with light anesthesia (26 ± 2 vs. 35 ± 24% of maximal genioglossus activation, respectively; P 0.001) and correlated with bispectral index (P 0.001). Upper airway closing pressure and genioglossus activity during airway occlusion did not differ between sevoflurane and propofol anesthesia. Conclusions:Propofol and sevoflurane anesthesia increased upper airway collapsibility i