Sathitkarnmanee Thepakorn, Tribuddharat Sirirat, Suttinarakorn Chakthip, Nonlhaopol Duangthida, Thananun Maneerat, Somdee Wilawan, Theerapongpakdee Sunchai
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Biomed Res Int. 2014;2014:867504. doi: 10.1155/2014/867504. Epub 2014 Jun 4.
We propose a 1-1-12 wash-in scheme for desflurane-nitrous oxide (N2O) low-flow anesthesia. The objective of our study was to determine the time to achieve alveolar concentration of desflurane (FAD) at 1, 2, 3, 4, 5, and 6%.
We enrolled 106 patients scheduled for elective surgery under general anesthesia. After induction and intubation, wash-in was started with a fresh gas flow (FGF) of N2O : O2 1 : 1 L min(-1) and vaporizer concentration of desflurane (FD) of 12%. Ventilation was controlled to maintain PACO2 at 30-35 mmHg.
The FAD rose rapidly from 0 to 4% in 2 min in a linear manner in 0.5 min increments. An FAD of 6% was achieved in 4 min in a linear fashion from FAD of 4% but in 1 min increments. An FAD of 1 to 6% occurred at 0.6, 1, 1.5, 2, 3, and 4 min. Heart rate during wash-in showed a statistically, albeit not clinically, significant pattern of increase. By contrast, blood pressure slightly decreased during this period.
We developed a 1-1-12 wash-in scheme using a FGF of N2O : O2 1 : 1 L min(-1) and FD of 12% for desflurane-nitrous oxide low-flow anesthesia. A respective FAD of 1, 2, 3, 4, 5, and 6% can be expected at 0.6, 1, 1.5, 2, 3, and 4 min.
我们提出了一种用于地氟醚-氧化亚氮（N₂O）低流量麻醉的1-1-12预充方案。本研究的目的是确定达到1%、2%、3%、4%、5%和6%地氟醚肺泡浓度（FAD）所需的时间。
我们纳入了106例计划在全身麻醉下进行择期手术的患者。诱导和插管后，开始预充，新鲜气流（FGF）为N₂O∶O₂ 1∶1 L·min⁻¹，地氟醚蒸发器浓度（FD）为12%。控制通气以维持动脉血二氧化碳分压（PACO₂）在30 - 35 mmHg。
FAD以0.5分钟的增量呈线性方式在2分钟内从0迅速升至4%。从4%的FAD开始，以线性方式在4分钟内达到6%的FAD，但增量为1分钟。1%至6%的FAD分别在0.6、1、1.5、2、3和4分钟出现。预充期间心率显示出有统计学意义（尽管无临床意义）的增加模式。相比之下，在此期间血压略有下降。
我们开发了一种用于地氟醚-氧化亚氮低流量麻醉的1-1-12预充方案，使用N₂O∶O₂ 1∶1 L·min⁻¹的FGF和12%的FD。预计在0.6、1、1.5、2、3和4分钟时分别达到1%、2%、3%、4%、5%和6%的FAD。
