Use of positive pressure in preoperative and intraoperative of bariatric surgery and its effect on the time of extubation

Revista Brasileira de Anestesiologia

Letícia Baltieri¹  Laisa Antonela Dos Santos¹  Irineu Rasera-junior¹  Maria Imaculada De Lima Montebelo¹  Eli Maria Pazzianotto-forti¹ 

关键词: Diseases;    Obesity;    Bariatric surgery;    Ventilation;    Doenças;    Obesidade;    Cirurgia bariátrica;    Ventilação mecânica;    pressão positiva;    Enfermedades;    Obesidad;    Cirugía bariátrica;    Ventilación mecánica;    presión positiva;   

DOI  :  10.1016/j.bjane.2013.10.021

来源: SciELO

【 摘 要 】

BACKGROUND AND OBJECTIVE: To investigate the influence of intraoperative and preoperative positive pressure in the time of extubation in patients undergoing bariatric surgery. METHOD: Randomized clinical trial, in which 40 individuals with a body mass index between 40 and 55 kg/m2, age between 25 and 55 years, nonsmokers, underwent bariatric surgery type Roux-en-Y gastric bypass by laparotomy and with normal preoperative pulmonary function were randomized into the following groups: G-pre (n = 10): individuals who received treatment with noninvasive positive pressure before surgery for 1 h; G-intra (n = 10): individuals who received positive end-expiratory pressure of 10 cm H2O throughout the surgical procedure; and G-control (n = 20): not received any preoperative or intraoperative intervention. Following were recorded: time between induction of anesthesia and extubation, between the end of anesthesia and extubation, duration of mechanical ventilation, and time between extubation and discharge from the post-anesthetic recovery. RESULTS: There was no statistical difference between groups. However, when applied to the Cohen coefficient, the use of positive end-expiratory pressure of 10 cm H2O during surgery showed a large effect on the time between the end of anesthesia and extubation. About this same time, the treatment performed preoperatively showed moderate effect. CONCLUSION: The use of positive end-expiratory pressure of 10 cm H2O in the intraoperative and positive pressure preoperatively, influenced the time of extubation of patients undergoing bariatric surgery.

【 授权许可】

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