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过度通气加速妇科患者动脉血中七氟醚浓度的升高。

Hyperventilation accelerates rise in arterial blood concentrations of sevoflurane in gynecologic patients.

机构信息

Department of Anesthesiology, Tri-Service General Hospital/National Defense Medical Center, Taipei, Taiwan.

出版信息

J Anesth. 2013 Feb;27(1):35-42. doi: 10.1007/s00540-012-1483-6. Epub 2012 Sep 19.

Abstract

PURPOSE

We investigated whether ventilation volumes affected arterial blood sevoflurane concentration (A (sev)) and its uptake into the body during general anesthesia.

METHODS

Thirty female patients undergoing elective gynecologic surgery were randomly allocated into three groups: hyperventilation, normal ventilation, and hypoventilation. Inspiratory (CI(sev)) and end-tidal ((sev)) sevoflurane concentrations were routinely measured by infrared analysis, and A (sev) were analyzed by gas chromatography for 40 min after intubation. Cardiac index and total peripheral vascular resistance were measured with a Finometer.

RESULTS

During the first 10 min after sevoflurane administration, A (sev) in the hyperventilation group was the highest and differed significantly from those in the normal ventilation group, followed by those in the hypoventilation group. In addition, hyperventilation significantly increased the slope of A (sev) over time in the first 5 min, but there were no differences in slopes in the 5-10, 10-20, and 20-40 min periods, which indicates no difference in sevoflurane bodily uptake among the three groups after 5 min.

CONCLUSION

Hyperventilation accelerated the rate of A (sev) increase immediately after sevoflurane administration, which was time dependent with respect to different alveolar ventilation levels.

摘要

目的

我们研究了通气量是否会影响全身麻醉期间动脉血七氟醚浓度(A(sev))及其在体内的摄取。

方法

30 名择期行妇科手术的女性患者随机分为三组:过度通气组、正常通气组和低通气组。通过红外线分析常规测量吸入(CI(sev))和呼气末((sev))七氟醚浓度,并在插管后 40 分钟内通过气相色谱法分析 A(sev)。使用 Finometer 测量心指数和总外周血管阻力。

结果

在给予七氟醚后的前 10 分钟内,过度通气组的 A(sev)最高,与正常通气组差异显著,其次是低通气组。此外,过度通气在第 1 至 5 分钟内显著增加了 A(sev)随时间的斜率,但在第 5-10、10-20 和 20-40 分钟期间斜率没有差异,这表明在 5 分钟后三组之间的七氟醚体内摄取没有差异。

结论

过度通气在给予七氟醚后立即加速了 A(sev)增加的速度,这与不同的肺泡通气水平呈时间依赖性。

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