Rainger J E, Dart C M, Perkins N R
University Veterinary Teaching Hospital Camden, University of Sydney, Camden, New South Wales 2570, Australia.
Aust Vet J. 2010 Jan;88(1-2):13-9. doi: 10.1111/j.1751-0813.2009.00535.x.
To assess the effects of the duration of anaesthesia, position of recumbency, mode of ventilation, anaesthetic drug protocol, patient age and type of surgical procedure on the usefulness of capnometry as a measure of the partial pressure of arterial carbon dioxide (P(a)co(2)) during general anaesthesia in horses.
A prospective study compared the P(a)co(2) values with those of partial pressure of end-tidal carbon dioxide (ETco(2)) in horses anaesthetised for elective or emergency surgical procedures. The difference between P(a)co(2) and ETco(2) (P(a)co(2)- ETco(2)) and the physiological dead space to tidal volume ratio (V(D)/V(T)) were calculated. The effects of the study parameters on these variables was determined.
The agreement between P(a)co(2) and ETco(2) was poor. P(a)co(2)- ETco(2) and V(D)/V(T) during the first 60 min of anaesthesia was significantly less than after 60 min of anaesthesia. Mode of ventilation, position of recumbency, anaesthetic drug protocol, patient age and type of procedure did not have a significant affect on either value.
P(a)co(2)- ETco(2) in anaesthetised horses can be large, making ETco(2) unreliable as a predictor of P(a)co(2) and for assessment of pulmonary ventilation. For anaesthesia lasting less than 60 min at least one blood gas analysis of an arterial blood sample is required to assess P(a)co(2)- ETco(2). Arterial blood gas analysis should be repeated after 60 min of general anaesthesia.
评估麻醉持续时间、卧位、通气模式、麻醉药物方案、患者年龄及手术类型对马全身麻醉期间二氧化碳监测法作为动脉血二氧化碳分压(P(a)co(2))测量方法有效性的影响。
一项前瞻性研究比较了接受择期或急诊手术麻醉的马的P(a)co(2)值与呼气末二氧化碳分压(ETco(2))值。计算了P(a)co(2)与ETco(2)之间的差值(P(a)co(2)-ETco(2))以及生理死腔与潮气量之比(V(D)/V(T))。确定了研究参数对这些变量的影响。
P(a)co(2)与ETco(2)之间的一致性较差。麻醉前60分钟内的P(a)co(2)-ETco(2)和V(D)/V(T)显著低于麻醉60分钟后。通气模式、卧位、麻醉药物方案、患者年龄和手术类型对这两个值均无显著影响。
麻醉马的P(a)co(2)-ETco(2)可能较大,使得ETco(2)作为P(a)co(2)的预测指标及评估肺通气不可靠。对于持续时间少于60分钟的麻醉,至少需要对一份动脉血样本进行一次血气分析以评估P(a)co(2)-ETco(2)。全身麻醉60分钟后应重复进行动脉血气分析。