Abstract: Objective To detect the right diaphragmatic motion of the patients with non thoracic abdominal surgery by using M-mode ultrasound in PACU and to get motion amplitude value when performing extubation. Methods The study enrolled 110 patients of whom 56 were male and 54 female with non-thoracic and abdominal surgery in the PACU who required extubation. Diaphragmatic movement was measured by a single well-trained doctor with a 2-5 MHz US probe placed over one of the lower intercostal spaces in the right anterior axillary line for the right diaphragm using an Esaote ultrasound machine before the anesthesia and during extubation as well as 10 and 30 mins after extubation. The liver was used as a window for right hemidiaphragm with the patient supine. The time ranges from muscle relaxants stopped to extubation,from muscle relaxants stopped to who could raise head for 5 s was recorded. And Ramsay score were recorded before the movement of extubation. Results Compared with those before anesthesia[male(16.8±2.6) mm, female(14.6±1.6) mm], extubation[male(13.1±1.4) mm, female(12.4±1.2) mm] was statistically significant in two groups of diaphragm motion amplitude difference (P<0.05), 10 min[male(15.7±2.7) mm, female(13.9±2.1) mm], 30 min[male(16.1±2.6) mm, female(14.3±2.0) mm] after extubation in two groups of diaphragm motion amplitude showed no significant difference(P>0.05). Compared with extubation, there was statistical significance after extubation in 10, 30 min two group of diaphragm the motion amplitude difference(P<0.05). 10 min after extubation and 30 min after extubation comparison, no statistically significant difference between the two groups of diaphragm motion amplitude (P>0.05). There is no Statistical significance between preoperative and being out of PACU. Conclusions The fact that M-mode ultrasound measures the right diaphragmatic motion range when performing extubation has higher operability and repeatability to evaluate the functional recovery of the diaphragm in PACU.
|