Effect and safety of pulmonary protective ventilation combined with intravenous inhalational anesthesia in children treated with electronic cochlear implantation

ZENG Ruxiao; TIAN Ye; LIU Xiaomei

PDF(1010 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2022, Vol. 33 ›› Issue (9) : 742-744.

Effect and safety of pulmonary protective ventilation combined with intravenous inhalational anesthesia in children treated with electronic cochlear implantation

ZENG Ruxiao, TIAN Ye, LIU Xiaomei

Author information +

History +

Abstract

Objective To study the effect and safety of pulmonary protective ventilation combined with intravenous inhalational anesthesia in pediatric electronic cochlear (CI) implantation.Methods Eighty children with severe or very severe sensorineural hearing loss (SNHL) who received CI implantation in the Sixth Medical Center of Chinese PLA General Hospital from October 2019 to October 2021 were selected as the research objects, and they were divided into the control group and the observation group by random number table method, with 40 cases in each group. Both groups were given intravenous inhalation combined anesthesia, the control group with conventional ventilation strategy and the observation group with lung protective ventilation strategy. The hemodynamic indexes before (T₀) and 30 min after (T₁) the ventilation strategy and the adverse reactions after anesthesia were compared between the two groups.Results At T₀, there were no significant differences in HR, MAP and SPO₂ between the two groups. At T₁, HR, MAP and SPO₂ in the two groups decreased, and the indexes of the observation group was lower than those of the control group (P<0.05). After treatment, MDA level [(6.21±0.19) μmol/L] in the observation group was significantly lower than that in the control group. SOD level [(90.77±11.54) U/L] was significantly higher than that of control group (P<0.05). The rate of the adverse reactions in the observation group (7.50%) was lower than that in the control group (27.50%)(P<0.05).Conclusions Pulmonary protective ventilation combined with intravenous inhalation anesthesia is safe and reliable, which can maintain hemodynamic stability during CI implantation in children, reduce patients’ stress response, and reduce the occurrence of adverse reactions after anesthesia recovery.

Key words

pulmonary protective ventilation strategy / intravenous inhalation combined anesthesia / sensorineural deafness / electronic cochlear implantation

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

ZENG Ruxiao, TIAN Ye, LIU Xiaomei. Effect and safety of pulmonary protective ventilation combined with intravenous inhalational anesthesia in children treated with electronic cochlear implantation[J]. Medical Journal of the Chinese People Armed Police Forces. 2022, 33(9): 742-744

References

[1] 高胜利,曾清香,温瑞金,等. 儿童单侧重度及极重度感音神经性耳聋88例资料分析 [J]. 中华耳科学杂志,2020, 18(2): 301-304.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会,中国残疾人康复协会听力语言康复专业委员会.人工耳蜗置入工作指南(2013) [J]. 中华耳鼻咽喉头颈外科杂志,2014, 49(2): 89-95.
[3] 殷霞丽,宋芬,栾笑溪. 右美托咪定麻醉在耳聋小儿人工耳蜗置入术中的效果及安全性分析 [J]. 解放军预防医学杂志,2019, 37(11): 76-77.
[4] 张雄. 改良耳后反S形双瓣技术在电子耳蜗置入术中的临床效果分析 [J]. 广西医科大学学报,2021, 38(4): 812-815.
[5] Bruijnzeel H, Wammes E, Stokroos R J, et al. A retrospective cohort study of adverse event assessment during anesthesia-related procedures for cochlear implant candidacy assessment and cochlear implantation in infants and toddlers[J]. Paediatr Anaesth, 2020, 30(9): 1033-1040.
[6] Vincenti V, Plantone F, Ciavarro G, et al. Cochlear implantation under local anesthesia and conscious sedation: an Italian experience[J].Eur Arch Otorhinolaryngol, 2021, 278(10): 3667-3672.
[7] 陈方园,杨悦,孙雪晨,等. 经皮穴位电刺激对小儿电子耳蜗置入术苏醒期躁动的影响 [J]. 中国医科大学学报,2017, 46(4): 298-301,305.
[8] 徐峰,王义桥,李查兵,等. 硫酸镁或右美托咪定复合罗哌卡因颈浅丛阻滞对人工耳蜗置入术后镇痛效果的比较 [J]. 蚌埠医学院学报,2020, 45(8): 1024-1028.
[9] 孙盈盈,刘俊霞,夏迎静,等. 长时间保护性单肺通气与新生儿术后康复指标的相关性 [J]. 临床麻醉学杂志,2021, 37(4): 372-376.
[10] 肖婷,张水兵,裴冬杰,等. 保护性通气策略对单肺通气患儿局部脑氧饱和度和S100β蛋白的影响 [J]. 临床麻醉学杂志,2021, 37(4): 395-398.
[11] Connors J R, Deep N L, Huncke T K, et al. Cochlear implantation under local anesthesia with conscious sedation in the elderly: first 100 cases[J]. Laryngoscope, 2021, 131(3): E946-E951.
[12] Kecskeméti N, Szönyi M, Küstel M, et al. Cochlear implantation under local anesthesia: a possible alternative for elderly patients[J]. Eur Arch Otorhinolaryngol,2019, 276(6): 1643-1647.
[13] 陈宇超,徐颖. 肺保护性通气策略在小儿腹腔镜手术中的研究进展[J]. 临床医学研究与实践,2019, 4(31): 197-198.
[14] 孙庆梅,张洪波,郭永民,等. 保护性通气策略联合糖皮质激素用于小儿腹腔镜手术机械通气所致肺损伤效果观察 [J]. 山东医药,2016, 56(20): 12-14.
[15] 邢泉生,荣佑宝,曹倩,等. 保护性机械通气和PGE1联用对婴幼儿体外循环术后急性肺损伤的保护作用[J]. 山东医药,2005, 45(6): 1-3.
[16] Colesa D J, Devare J, Swiderski D L, et al. Development of a chronically-implanted mouse model for studies of cochlear health and implant function[J]. Hear Res, 2021, 404: 108216.
[17] 梁玉丹,李静洁,刘博研,等. 丙泊酚和七氟烷对电子耳蜗置入术婴幼儿肠道菌群多样性的影响 [J]. 医学研究生学报,2020, 33(3): 285-288.
[18] 陈文英,谷海飞. 肺保护性通气策略联合超声引导下TAP阻滞在小儿日间腹腔镜疝气修补术中的临床观察 [J]. 中外医学研究,2021, 19(16): 10-12.
[19] 谷海飞,李超,杨峰. 肺保护性通气策略联合不同麻醉方式对小儿腹腔镜下胆总管囊肿根治术的影响 [J]. 临床医学研究与实践,2021, 6(26): 47-49.