手术期间麻醉给药与通气的自动控制。

Ritchie R G, Ernst E A, Pate B L, Pearson J P, Sheppard L C

Department of Anesthesiology, School of Medicine, University of Alabama, Birmingham 35294.

Med Prog Technol. 1990 May;16(1-2):61-7.

Use of a closed rebreathing circuit for anesthesia delivery offers several advantages: conservation of anesthetic agent, natural heating and humidification of inspired gases, less pollution, and improved monitoring. However, the technique requires careful control of the fresh gas and anesthetic delivery. An anesthesia delivery system has been developed which automatically controls fresh gas delivery, anesthetic delivery, and ventilation in order to regulate circuit volume, oxygen concentration, end-tidal anesthetic concentration, and end-tidal PCO2. This system makes available the advantages of closed-circuit anesthesia without encumbering the anesthesiologist with its more demanding control tasks. The system has undergone clinical testing in adult surgical patients. Maintenance of circuit volume, oxygen concentration, end-tidal anesthetic concentration, and end-tidal PCO2 was achieved by the system in all patients but the first. The anesthetic delivery controller required tuning on the first patient. No further tuning was required for any of the other patients or controllers. During abdominal surgery, the end-tidal bellows position measurement and end-tidal anesthetic concentration measurement increased in variability. The cause of the variability and its elimination are discussed in the article.

使用封闭再呼吸回路进行麻醉给药有几个优点

节省麻醉剂、对吸入气体进行自然加热和加湿、减少污染以及改善监测。然而，该技术需要仔细控制新鲜气体和麻醉剂的输送。已经开发出一种麻醉输送系统，它能自动控制新鲜气体输送、麻醉剂输送和通气，以调节回路容积、氧浓度、呼气末麻醉剂浓度和呼气末二氧化碳分压。该系统提供了闭路麻醉的优点，同时又不会让麻醉医生承担其要求更高的控制任务。该系统已在成年外科患者中进行了临床测试。除了第一例患者外，该系统在所有患者中都实现了回路容积、氧浓度、呼气末麻醉剂浓度和呼气末二氧化碳分压的维持。麻醉输送控制器在第一例患者身上需要进行调整。其他任何患者或控制器都无需进一步调整。在腹部手术期间，呼气末波纹管位置测量和呼气末麻醉剂浓度测量的变异性增加。本文讨论了变异性的原因及其消除方法。