Drummond G B, Park G R
Br J Anaesth. 1984 Sep;56(9):987-93. doi: 10.1093/bja/56.9.987.
Arterial oxygenation in patients was measured with an ear oximeter to assess factors that were associated with hypoxaemia at the induction of anaesthesia. Twenty patients breathed air during the induction of anaesthesia with thiopentone and following neuromuscular blockade with suxamethonium. Mean SaO2 decreased from 95.7% before induction to 85.5% 1 min after induction. The SaO2 at 1 min was less in those patients whose weight was more than expected (SaO2 80.5%), than in those patients whose weight was as expected or less than expected (SaO2 88.8%). Other factors such as haemoglobin concentration, FEV1, FVC, age, or smoking habits, were not related to the degree of arterial desaturation. To assess the efficacy of different methods of oxygen administration, four groups of 10 patients, were given oxygen in different ways using a Magill anaesthetic system with a supply of 10 litre min-1. Measurements were made for up to 3 min after the induction of anaesthesia and maintenance of apnoea. Group I breathed normally from the system for 1 min before anaesthesia was induced. Group II were treated similarly, but the mask had a standardized "leak", a 9.5-mm diameter hole. Group III took three vital capacity breaths from the system before anaesthesia, and group IV breathed air before anaesthesia, but their lungs were given three maximal manual inflations after the induction of anaesthesia. Mean SaO2 values after 3 min apnoea were: 96.8% (group I), 93.6% (group II), and 98.0% (group III). In group IV, measurements were stopped at 2 min when mean SaO2 was 92.9%.(ABSTRACT TRUNCATED AT 250 WORDS)
使用耳血氧计测量患者的动脉氧合情况,以评估与麻醉诱导期低氧血症相关的因素。20例患者在硫喷妥钠诱导麻醉及琥珀酰胆碱进行神经肌肉阻滞期间呼吸空气。平均血氧饱和度(SaO2)从诱导前的95.7%降至诱导后1分钟的85.5%。体重超过预期的患者诱导后1分钟时的SaO2(80.5%)低于体重符合预期或低于预期的患者(88.8%)。血红蛋白浓度、第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、年龄或吸烟习惯等其他因素与动脉血氧饱和度降低程度无关。为评估不同给氧方法的效果,将四组每组10例患者,使用流量为10升/分钟的Magill麻醉系统以不同方式给予氧气。在麻醉诱导及呼吸暂停维持后最多测量3分钟。第一组在麻醉诱导前从系统正常呼吸1分钟。第二组处理方式类似,但面罩有一个标准化“泄漏”,即直径9.5毫米的孔。第三组在麻醉前从系统进行三次肺活量呼吸,第四组在麻醉前呼吸空气,但在麻醉诱导后对其肺部进行三次最大程度的手动充气。呼吸暂停3分钟后的平均SaO2值分别为:第一组96.8%,第二组93.6%,第三组98.0%。第四组在2分钟时平均SaO2为92.9%,此时停止测量。(摘要截选至250字)