Lampe G H, Wauk L Z, Whitendale P, Way W L, Kozmary S V, Donegan J H, Eger E I
Department of Anesthesia, University of California, San Francisco 94143-0464.
Anesth Analg. 1990 Dec;71(6):597-601.
We tested whether anesthesia that includes nitrous oxide (N2O) results in the development of intraoperative and postoperative pulmonary complications, including hypoxemia. We also tested whether aging contributes to the development of such complications, particularly when anesthesia includes N2O. We randomly allocated patients having total hip replacements, carotid endarterectomies, or transsphenoidal hypophysectomies (total n = 270) to an anesthetic regimen with and without N2O (stratified within surgical group). A heat-and-moisture exchanger was included in the anesthetic circuit of all patients. Patients were monitored perioperatively and for 1 wk after surgery using intermittent and continuous pulse oximetry to determine oxyhemoglobin saturation. Intraoperatively, mean oxygen (O2) saturations were lower in patients given N2O, particularly older patients. Hypoxemia (O2 saturation less than 86%) developed in five patients receiving N2O and in one receiving O2. This difference was not significant. Administration of N2O did not decrease postoperative O2 saturation, nor did it alter the incidence of postoperative hypoxemia, cough, or sputum production.
我们测试了包含一氧化二氮（N₂O）的麻醉是否会导致术中及术后肺部并发症的发生，包括低氧血症。我们还测试了衰老是否会促使此类并发症的发生，尤其是当麻醉中包含N₂O时。我们将接受全髋关节置换术、颈动脉内膜切除术或经蝶垂体切除术的患者（总计n = 270）随机分配至使用或不使用N₂O的麻醉方案组（在手术组内进行分层）。所有患者的麻醉回路中均包含一个热湿交换器。围手术期及术后1周对患者进行监测，使用间歇性和持续性脉搏血氧饱和度测定法来确定氧合血红蛋白饱和度。术中，使用N₂O的患者，尤其是老年患者，平均氧（O₂）饱和度较低。接受N₂O的5名患者和接受O₂的1名患者出现了低氧血症（O₂饱和度低于86%）。这种差异不显著。使用N₂O并未降低术后O₂饱和度，也未改变术后低氧血症、咳嗽或咳痰的发生率。
