麻醉气体监测与最低肺泡浓度监测中患者入院情况的观察性研究：一个影响巨大的缺陷。
An observational study on patient admission in the anaesthesia gas monitor and minimum alveolar concentration monitoring: A deficiency with huge impact.
作者信息
Karim Habib Md Reazaul, Narayan Anilkumar, Yunus Md, Kumar Sanjay, Prakash Avinash, Sahoo Sarasa Kumar
机构信息
Department of Anaesthesiology, Andaman and Nicobar Islands Institute of Medical Sciences and GB Pant Hospital, Port Blair, Andaman and Nicobar Islands, India.
Department of Anaesthesiology, Critical Care and Pain Medicine, North Eastern Indira Gandhi Regional Institute of Medical and Health Sciences, Shillong, Meghalaya, India.
出版信息
Indian J Anaesth. 2017 Jul;61(7):570-574. doi: 10.4103/ija.IJA_11_17.
BACKGROUND AND AIMS
Minimum alveolar concentration (MAC) monitoring is an integral part of modern-day anaesthesia. Both MAC and MAC-awake are age dependant, and age of the patient needs to be entered in the monitor. This study was aimed to assess the practice of patient birth year entry in the anaesthesia monitor and its impact on MAC monitoring.
METHODS
Sixty volatile anaesthetic-based general anaesthetics (GAs) were observed silently in two tertiary care teaching hospitals with regard to 'birth year' entry in the patient monitor. The impact on MAC for non-entry of age was assessed. The observed MAC reading and the MAC corrected for age (MAC) of the patients were noted. Paired -test was used to compare the differences in observed MAC and MAC values. <0.05 was significant.
RESULTS
Sixty GAs of patients aged between 10 and 68 years were observed; 96.67% anaesthetics were conducted without entering 'birth year'. Thirty-four patients (mean age 35.14 ± 15.38 years) were further assessed for impact of non-entry of age. The observed MAC was similar to MAC in patients aged 40 ± 5 years (36-45 years group). Nearly 79.41% of the observed MACs were incorrect; 55.88% patients were potentially underdosed whereas 23.53% were overdosed.
CONCLUSION
Omitting patient age entry in the monitor results in erroneous MAC values, exposing patients <40 years to underdosing and older patients to overdose.
背景与目的
最低肺泡浓度（MAC）监测是现代麻醉的一个重要组成部分。MAC和清醒MAC都与年龄相关，需要在监测仪中输入患者的年龄。本研究旨在评估在麻醉监测仪中输入患者出生年份的情况及其对MAC监测的影响。
方法
在两家三级护理教学医院，对60例基于挥发性麻醉剂的全身麻醉（GA）进行了关于患者监测仪中“出生年份”输入情况的观察。评估了未输入年龄对MAC的影响。记录观察到的MAC读数以及根据患者年龄校正后的MAC（MAC）。采用配对t检验比较观察到的MAC与MAC值之间的差异。P<0.05具有统计学意义。
结果
观察了60例年龄在10至68岁之间患者的GA；96.67%的麻醉操作未输入“出生年份”。对34例患者（平均年龄35.14±15.38岁）进一步评估未输入年龄的影响。观察到的MAC与40±5岁患者（36至45岁组）的MAC相似。近79.41%观察到的MAC值不正确；55.88%的患者可能用药不足，而23.53%的患者用药过量。
结论
在监测仪中遗漏患者年龄输入会导致MAC值错误，使40岁以下患者用药不足，老年患者用药过量。
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