肺活量诱导与潮气量通气诱导技术在麻醉诱导和化合物 A 生产中的比较。

A comparison between vital capacity induction and tidal breathing induction techniques for the induction of anesthesia and compound A production.

机构信息

Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.

出版信息

Chin Med J (Engl). 2010 Sep;123(17):2336-40.

PMID:21034545

Abstract

BACKGROUND

Vital capacity induction and tidal breathing induction are currently administered for inhalation induction of anesthesia with sevoflurane. The aim of this study was to compare them using sevoflurane with respect to induction time, complications of inhalation induction, and compound A production in adult patients.

METHODS

Fifty-one women with American Society of Anesthesiologists physical status I-II undergoing mammary gland tumorectomy were randomly assigned to receive either vital capacity induction or tidal breathing induction with 8% sevoflurane at 6 L/min followed by laryngeal mask airway insertion. Induction times, complications of inhalation induction, and vital signs were recorded. Inspired concentrations of compound A were assayed and sofnolime temperatures were monitored at one-minute intervals after sevoflurane administration.

RESULTS

The time to loss of eyelash reflex was significantly shorter with the vital capacity induction technique than with the tidal breathing induction technique ((43.8 ± 13.4) seconds vs. (70.8 ± 16.4) seconds, respectively; P < 0.01). Cardiovascular stability was similar in both groups. The incidence of complications was significantly less with the vital capacity induction technique than with the tidal breathing induction technique (7.7% vs. 32%, respectively; P < 0.01). However, the mean and maximum concentrations of compound A during induction were significantly higher in the vital capacity group than those in the tidal breathing group (P < 0.05); compound A concentration at the beginning of anesthesia maintenance was (40.73 ± 10.83) ppm in the vital capacity group and (29.45 ± 7.51) ppm in tidal breathing group (P = 0.019).

CONCLUSION

For inhalation induction of anesthesia, the vital capacity induction was faster and produced fewer complications than that for tidal breathing induction, but increased compound A production in the circuit system.

摘要

背景

目前，七氟醚用于吸入诱导全身麻醉时，常采用潮气呼吸法或肺活量法。本研究旨在比较这两种方法在成人患者中应用 8%七氟醚（6 L/min）行吸入诱导时的诱导时间、吸入诱导并发症以及复合物 A 的产生情况。

方法

选择 51 例美国麻醉医师协会（ASA）分级 I-II 级的女性患者，拟行乳腺肿瘤切除术，随机分为两组，分别采用潮气呼吸法或肺活量法接受 8%七氟醚（6 L/min）吸入诱导，然后插入喉罩。记录诱导时间、吸入诱导并发症及生命体征。在给予七氟醚后 1 分钟间隔测定吸入气中复合物 A 的浓度，并监测 Sofnolime 温度。

结果

与潮气呼吸法相比，肺活量法诱导时眼睫毛反射消失时间更短（（43.8 ± 13.4）秒 vs. （70.8 ± 16.4）秒；P < 0.01）。两组患者的心血管稳定性相似。肺活量法组并发症发生率明显低于潮气呼吸法组（7.7% vs. 32%；P < 0.01）。然而，肺活量组在诱导期间的平均和最高复合物 A 浓度均明显高于潮气呼吸组（P < 0.05）；麻醉维持时开始时的复合物 A 浓度在肺活量组为（40.73 ± 10.83）ppm，在潮气呼吸组为（29.45 ± 7.51）ppm（P = 0.019）。