Author/Editor		Obran, Simona; Križmarić, Miljenko
Title		Dinamika naraščanja tlaka v tesnilnem mešičku sapničnega tubusa zaradi difuzije dušikovega oksidula med splošno anestezijo
Translated title		Dynamics of nitrous oxyde diffusion in tracheal tube cuff during general anesthesia
Type		članek
Source		In: Zbornik predavanj Maribor : Fakulteta za zdravstvene vede
Publication year		2014
Volume		str. 147-151
Language		slv
Abstract		Uvod Dušikov oksidul (N2O) med daljšimi operacijami v splošni anesteziji difundira v tesnilni mešiček sapničnega tubusa, ga razširi in posledično poveča tlak. Posledice so lahko ishemične poškodbe sluznice sapnika, kar se izraža z bolečim grlom ali hripavostjo. Namen študije je bil raziskati dinamiko difuzije N2O v tesnilni mešiček. Raziskovalna metodologija Raziskava je potekala v Splošni bolnišnici Ptuj, kjer smo v vzorec vključili 45 bolnikov s posegom v abdomnu. Z manometrom smo spremljali spremembe tlaka in jih zabeležili ob intubaciji, ter v intervalih po 10 minut do konca anestezije. V drugem delu raziskave smo s kratko telefonsko anketo preverili, kakšna je praksa po drugih bolnišnicah v Sloveniji glede nadzora tlaka v mešičku. Rezultati Naraščanje tlaka v tesnilnem mešičku tubusa se začne po 15 minutah uporabe N2O. Večje naraščanje tlaka je bolj opazno pri višjih koncentracijah N2O (55 % in 60 %), ko lahko tlak naraste dva do trikrat po 50 minutah. Ugotovili smo, da obstaja statistična razlika tlakov v različnih časovnih intervalih (p<0,01). V Sloveniji se nadzor na tlakom v mešičku praktično ne izvaja. Sklep Uvedba nadzora nad tlakom v mešičkih sapničnih tubusov med splošno anestezijo z N2O bi morala postati ustaljena praksa, saj bi tako bolniku po ekstubaciji v pooperativnem obdobju preprečili bolečine in neprijetne občutke v grlu.During longer general anesthesia nitrous oxide (N2O) diffuses into the tracheal tube cuff where consequently increases the pressure. This causes ischemic injuries to the tracheal mucosa, which results in a sore throat or hoarseness following surgery under. The aim of the research was to determine the dynamics of N2O diffusion into the tracheal tube cuff. Research method The research was based on a quantitative methodology, carried out at the General hospital Ptuj. 45 abdominal surgery patients were included in the study. We monitored the pressure changes dynamics within the cuff with a manometer and measured it at the intubation and then in 10 minute intervals throughout the entire anesthesia process. For the second part of the research we conducted a short telephone survey to inquire about the cuff pressure monitoring practices in other hospitals across Slovenia. Results The pressure in the cuff of the tracheal tube starts increasing after 15 minutes of administering nitrous oxide (N2O). The pressure increase is more prominent with higher N2O concentrations (55% and 60%), where the pressure can increase by a factor of 2 to 3 after 50 minutes of administering N2O. We identified a statistically significant difference between the pressure within the cuffs of the tracheal tube during general anesthesia (p<0.01). In Slovenia is not performed cuff pressure monitoring. Conclusion The introduction of monitoring and measuring of pressure in endotracheal tube cuffs during general anesthesia with nitrous oxide should become standard that prevents postoperative throat pain and discomfort with patients following the extubation.
Keywords		dušikov oksidul tesnilni mešiček sapničnega tubusa splošna anestezija difuzija nitrous oxide tracheal tube cuff general anesthesia diffusion