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绵羊对静脉麻醉与吸入麻醉的肺容积及通气/血流比值分布反应

Lung volume and VA/Q distribution response to intravenous versus inhalation anesthesia in sheep.

作者信息

Dueck R, Rathbun M, Greenburg A G

出版信息

Anesthesiology. 1984 Jul;61(1):55-65.

PMID:6742484
Abstract

The effects of intravenous pentobarbital versus nitrous oxide/halothane inhalation anesthesia on blood gases, distribution of ventilation-perfusion ratios (VA/Q), and lung volume (FRC) were compared in 8 tracheostomized sheep in the lateral decubitus position. Pentobarbital anesthesia produced no significant changes (from awake control) in arterial blood PO2 or PCO2, ventilation-perfusion inequality, intrapulmonary shunt, or FRC during either spontaneous breathing or mechanical ventilation with muscle paralysis. With inhalation anesthesia, PaO2 decreased from 132 +/- 13 mmHg awake to 106 +/- 11 mmHg and 104 +/- 6 mmHg (FIO2 all 0.3) during spontaneous and mechanical ventilation. Shunt increased from 1.4 +/- 1.0% awake to 10.6 +/- 4.5 and 13.9 +/- 5.3%, respectively. Mean VA/Q decreased from 0.39 +/- 0.07 awake, to 0.21 +/- 0.06 and 0.29 +/- 0.07. Log standard deviation of VA/Q increased from 0.66 +/- 0.12 awake to 0.83 +/- 0.28 and 0.89 +/- 0.15. FRC decreased from 1.66 +/- 0.65 1 to 1.46 +/- 0.62 and 1.22 +/- 0.63 1, respectively. Differences in response to intravenous versus inhalation anesthesia for the above variables all were statistically significant at P less than 0.05. FRC and shunt changes with anesthesia showed significant correlation for both spontaneous (r = -0.80) and mechanical ventilation (r = 0.77), P less than 0.005 for both. We therefore propose that the differences between lung volume and gas exchange effects of intravenous versus inhalation anesthesia in sheep may have been related causally.

摘要

在8只侧卧的气管切开绵羊中,比较了静脉注射戊巴比妥与氧化亚氮/氟烷吸入麻醉对血气、通气/灌注比(VA/Q)分布和肺容量(功能残气量,FRC)的影响。戊巴比妥麻醉期间,无论是自主呼吸还是肌肉麻痹状态下的机械通气,动脉血氧分压(PO2)或二氧化碳分压(PCO2)、通气/灌注不均、肺内分流或功能残气量与清醒对照相比均无显著变化。吸入麻醉时,自主呼吸和机械通气期间,动脉血氧分压(PaO2)分别从清醒时的132±13 mmHg降至106±11 mmHg和104±6 mmHg(所有情况下吸入氧分数均为0.3)。分流率分别从清醒时的1.4±1.0%增至10.6±4.5%和13.9±5.3%。平均VA/Q从清醒时的0.39±0.07降至0.21±0.06和0.29±0.07。VA/Q的对数标准差从清醒时的0.66±0.12增至0.83±0.28和0.89±0.15。功能残气量分别从1.66±0.65 L降至1.46±0.62 L和1.22±0.63 L。上述变量对静脉麻醉与吸入麻醉的反应差异在P<0.05时均具有统计学意义。功能残气量和分流率随麻醉的变化在自主呼吸(r=-0.80)和机械通气(r=0.77)时均显示出显著相关性,两者P均<0.005。因此,我们认为绵羊静脉麻醉与吸入麻醉在肺容量和气体交换效应上的差异可能存在因果关系。

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