使網路閱讀成為最高樂趣。

硬膜外導管的大小和流速是否影響不同程序化間歇硬膜外注射方式的注射壓力


麻醉MGDECSFRABIPDPIEBR?AI...

- 2018年11月06日01時26分
- 科學文摘 / 麻醉MedicalGroup

麻醉MedicalGroup

Do Epidural Catheter Size and Flow Rate Affect Bolus Injection Pressure in Different Programmed Intermittent Epidural Bolus Regimens? An In Vitro Study

背景與目的

用於分娩鎮痛的最佳程序化間歇硬膜外推注方式仍然未知。一些研究表明硬膜外腔中更好的藥物擴散是由於注射壓力增加引起的; 然而,缺乏關於使用硬膜外輸注泵對不同導管和流速所產生的最大壓力的數據。


方 法

我們評估了11種常用硬膜外導管的流速和壓力特徵,並結合3種不同的輸液泵,根據設置的間歇性硬膜外推注方式進行硬膜外輸注。在100,250和400m.h-1的流速下測量壓力變化,且推注體積為10mL。為了避免重複測量,使用線性混合模型。通過逐步篩選特徵,直到模型中僅剩下統計學上具有顯著差異的變量。

結 果

我們進行了660次測量。對於不同的流速和導管設計,在推注期間產生的平均最大壓力範圍為86至863mmHg。流速和導管規格之間的相互作用導致18G,19G和20G導管的壓力分別增加1.31,1.65和2.00mmHg,以1mL.h-1增加流速(P

<.001)。包括對鋼絲增強導管的分析顯示,對於18G,19G和20G導管,以1mL.h-1增加流速,壓力分別增加1.16,1.76和2.36 mmHg(P <.001)。在某些情況下,它會觸發輸注泵堵塞警報。


結 論

在各種導管和流速組合中的體外最大壓力值中存在顯著差異,對於研究中使用的鋼絲增強導管壓力值更高。最佳的流速和硬膜外導管組合可允許藥物以高流速輸注而不觸發輸注泵堵塞警報。

原始文獻摘要

Krawczyk P, Piwowar P, Sałapa K, Lonc T, Andres J;Do Epidural Catheter Size and Flow Rate Affect Bolus

Injection Pressure in Different Programmed Intermittent Epidural Bolus Regimens? An In Vitro Study;Anesth Analg.2018 Jul 17. doi: 10.1213/ANE.0000000000003650.

BACKGROUND: The optimal programmed intermittent epidural bolus regimen for labor analgesia remains unknown. Some studies indicate that better drug spread in the epidural space

results from greater injection pressure; however, there is a lack of data regarding the maximum pressure generated by epidural bolus injection using different catheters and flow rates.

METHODS: We evaluated the flow and pressure characteristics of 11 commonly used epidural catheters combined with 3 different infusion pumps that deliver epidural infusions

according to the programmed intermittent epidural bolus regimen. Pressure changes were measured over time at flow rates of 100, 250, and 400 mL・hour−1 and with a bolus volume of 10 mL. To account for


repeated measures, linear mixed models were used. Features were selected with a backward stepwise procedure continued until only statistically significant variables were left in the model.

RESULTS: We performed 660 measurements. The mean maximal pressure generated during bolus injection ranged from 86 to 863 mm Hg for different flow rates and catheter designs. The

interaction between flow rate and catheter gauge resulted in 1.31, 1.65, and 2.00 mm Hg of pressure increase for 18G, 19G, and 20G catheters, respectively, per 1 mL・hour−1 of increased flow rate

(P < .001). Analyses including wire-reinforced catheters revealed a 1.16, 1.76, and 2.36 mm Hg pressure increase for 18G, 19G, and 20G catheters, respectively, per 1 mL・hour−1 of

increased flow rate (P < .001). In some cases, it triggered the occlusion pump alarm.

CONCLUSIONS: Significant differences were observed in the in vitro maximum pressure value among the various catheter and flow rate combinations with a higher pressure value for

wirereinforced catheters used in the study. The optimal flow rate and epidural catheter combination may allow for delivery of the bolus with high flow rate without triggering the occlusion alarm.

溫馨提示:本平台已開通文章搜索功能,可關注後發送關鍵詞體驗。

歡迎您在下方留言↓↓↓


熱門內容

友善連結



八方快聞是一個網路文摘網站,在浩瀚的網海中摘選即時的、優質的、知識的及趣味性的網路文章給大家欣賞,八方快聞努力做到讓每一個人,能夠使用所有裝置在不同時間地點,都能夠輕鬆享受數位時代的閱讀樂趣。