Enekvist Bruno, Johansson Anders
AANA J. 2016 Aug;84(4):255-9.
Variables measured in modern pulse oximetry apparatuses include a graphic pulse curve and a specified perfusion value (PV) that could be a sensitive marker for detecting differences in sympathetic activity. We hypothesized that there is a correlation between a reduction of PV and the time to eye opening after anesthesia with propofol-remifentanil. This study includes 29 patients, ASA physical status 1 or 2, scheduled for elective thyroid surgery. Main outcome measures were PV measured by pulse oximetry, heart rate, and noninvasive mean arterial blood pressure recorded before anesthesia, 15 minutes after induction, and at start of surgery, end of surgery, and eye opening at the end of anesthesia. Carbon dioxide (PETCO2) and oxygen inspiratory (FI-PO2) and expiratory (FE-PO2) concentrations were measured at all times except before anesthesia. Results demonstrated that PVs before anesthesia and at eye opening were lower than 15 minutes after induction and at end of surgery (P < .05). The PETCO2 and difference of FI-PETO2 increased at eye opening compared with the end of surgery (P <.05). We conclude that the pulse oximetry PV and the increased PETCO2 could be useful variables to predict timing of recovery in terms of eye opening after intravenous anesthesia.
现代脉搏血氧仪设备测量的变量包括图形脉搏曲线和特定灌注值(PV),该值可能是检测交感神经活动差异的敏感标志物。我们假设PV降低与丙泊酚-瑞芬太尼麻醉后睁眼时间之间存在相关性。本研究纳入了29例计划行择期甲状腺手术、ASA身体状况为1或2级的患者。主要观察指标包括麻醉前、诱导后15分钟、手术开始时、手术结束时以及麻醉结束时睁眼时通过脉搏血氧仪测量的PV、心率和无创平均动脉血压。除麻醉前外,所有时间均测量二氧化碳(PETCO2)以及吸气(FI-PO2)和呼气(FE-PO2)氧浓度。结果表明,麻醉前和睁眼时的PV低于诱导后15分钟和手术结束时(P <.05)。与手术结束时相比,睁眼时PETCO2以及FI-PETO2差值增加(P <.05)。我们得出结论,脉搏血氧仪PV以及PETCO2升高可能是预测静脉麻醉后睁眼恢复时间的有用变量。