自然気道で自発呼吸を温存する静脈麻酔管理による先天性心疾患心臓カテーテル検査において呼吸介入を必要とする因子の検討：単施設後ろ向き研究

Factors Associated with the Need for Respiratory Intervention in Congenital Heart Catheterization under Spontaneous Ventilation with Intravenous Anesthesia

要旨

　先天性心疾患を対象とした心臓カテーテルの麻酔において，呼吸の変化は検査結果に影響を与えるため呼吸管理は重要で適切な介入が必要であるが，正確な検査を目的とした自発呼吸中の呼吸介入必要因子を検討した報告はない。今回，自然気道・自発呼吸下の心臓カテーテル検査における呼吸介入に関する患者・麻酔因子を単施設後ろ向きに検討した。麻酔薬（プロポフォール＋レミフェンタニル）が呼吸介入必要因子であった。

　Background：Because respiratory change affects congenital heart catheter study, respiratory intervention under positive pressure ventilation or spontaneous ventilation is required. But the factors requiring intervention under spontaneous ventilation have not been examined.

　Methods：Patients who underwent diagnostic catheterization under spontaneous ventilation between 2018 and 2021 were retrospectively enrolled. The intervention is defined as head tilt, oral or nasal airway, laryngeal mask airway, and endotracheal intubation.

　Multiple logistic regression analysis was performed using intervention as the dependent variable. The independent variables were age, premedication, induction methods and the type of anesthetics.

　Results：Of the 296 patients, 45 patients needed respiratory intervention. The multiple logistic regression analysis revealed that the anesthetic（propofol＋remifentanil）was a significant factor.

　Conclusions：The factor requiring respiratory intervention under spontaneous ventilation was the type of anesthetics（propofol＋remifentanil）.