ABSTRACT
Objective To observe the effect of 15°-head up tilt position on quality of respiratory system during anesthesia recovery period in obese patients.Methods Eighty obese patients in ASA physical status Ⅰ or Ⅱ,aged 18-60 years,with BMI≥28 kg/m2,scheduled for elective otological surgery with microscopy,were randomly divided into 2 equal groups (n =40 each):the 15°-head up tilt position group (group H) and the supine position group (group C).With traditional induction,an esthesia was maintained by TCI of propofol 2-4 μg/ml and remifentanil 5-6ug/ml,not supplying muscle relaxant during operation.After operation,group H was in 15°-head up tilt position,while group C in supine position.The time spans from recovery of spontaneous breathing to meeting the extubation standard (X) and to meeting the standard for discharging form PACU (Y) were recorded.After extubation,we also recorded the time for SpO2decreased from 100％ to 92％ with fresh air (Z) and for SpO2 increased from 92％ to 100％ with pure oxygen (W).PaO2,PaCO2 and pH were monitored before oxygen inhalation,after 3 min of oxygen inhalation,at the end of surgery,before extubation and before discharging from PACU.Results Compared with group C [(19±6) min,(57±10) min,(51 ±9) s],the time of X (14±7) min,Y (45±7) min and W (39±11) s,was significantly shorter and the time of W was obviously longer in group H(P＜0.05).Compared with group C [(169.1± 29.4) mm Hg,(70.8±4.1) mm Hg],the PaO2was increased obviously before extubation and discharging from PACU in group H [(193.4±30.5) mm Hg,(82.2±3.4) mm Hg](P＜0.05).There was no significantly difference in PaO2 at other time points.There was no significantly difference in PaCO2and pH at all points.Conclusion 15°-head up tilt position during anesthesia recovery period in obese patients can effectively improve the quality of respiratory system.