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腹部手术全身麻醉期间手动技术与使用呼吸机进行控制呼吸的比较。

Comparison of controlled respiration by the manual technique and with a respirator during general anaesthesia for abdominal operations.

作者信息

Rychlewski W

出版信息

Anaesth Resusc Intensive Ther. 1975 Jan-Mar;3(1):57-68.

PMID:239610
Abstract

These studies investigating the difference between controlled respiration performed by manual technique and controlled respiration applied by means of a respirator during general anaesthesia, and assessing the influence of these methods on the immediate post-operative condition of the patient were carried out on 75 patients during abdominal operations. Gasometric tests in arterial blood were performed before premedication, at intervals of 30 min from the beginning of operation, and 10 min. after the removal of the endotracheal tube. Controlled respiration with a respirator is a more favourable method of pulmonary ventilation during general anaesthesia given for a long-lasting surgical operation. The manual technique of controlled respiration leads to respiratory alkalosis. The best results were obtained using a respirator with inspiratory volume of 10 ml/kg and respiratory frequency 10/min., which ensured normocapnia. It was observed that oxygenation of arterial blood was reduced postoperatively in all patients but the value of PaO2 was the lowest in patients on manual controlled respiration. Disturbances in acid-base balance and oxygenation had an unfavourable effect and delayed the regaining of consciousness.

摘要

这些研究对75例腹部手术患者进行,旨在调查全身麻醉期间手动技术控制呼吸与借助呼吸机控制呼吸之间的差异,并评估这些方法对患者术后即刻状况的影响。在术前用药前、手术开始后每隔30分钟以及拔除气管导管后10分钟进行动脉血气分析。对于长时间的外科手术,在全身麻醉期间使用呼吸机控制呼吸是一种更有利的肺通气方法。手动控制呼吸技术会导致呼吸性碱中毒。使用吸气量为10 ml/kg、呼吸频率为10次/分钟的呼吸机可获得最佳效果,可确保正常碳酸血症。观察到所有患者术后动脉血氧合均降低,但手动控制呼吸患者的PaO2值最低。酸碱平衡和氧合紊乱产生了不利影响,延迟了意识恢复。

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