Aalto-Setälä M, Heinonen J
Acta Anaesthesiol Scand. 1982 Dec;26(6):550-3. doi: 10.1111/j.1399-6576.1982.tb01816.x.
Total oxygen delivery (cardiac output X arterial oxygen content) and oxygen consumption were determined in 22 patients undergoing one-lung ventilation (OLV) during thoracotomy. In 11 patients, anaesthesia was maintained with halothane-oxygen and in another 11 patients with nitrous oxide-oxygen-analgesic combination (FIO2 0.5). During OLV, oxygen delivery was greater in the halothane group and these patients tended to show a decrease in oxygen consumption compared with the patients of the nitrous oxide group. Therefore, as far as total oxygen balance (oxygen delivery/oxygen consumption) during OLV is concerned, halothane-oxygen maintenance provides a greater margin of safety than nitrous oxide-oxygen-analgesic combination. However, in spite of occasional hypoxaemic episodes, none of our patients receiving 50% nitrous oxide in oxygen showed an oxygen delivery coefficient (oxygen delivery/oxygen consumption) significantly smaller than the predicted normal value for an unanaesthetized patient. This finding may explain why this anaesthetic technique has been used without apparent harm during OLV in patients with unimpaired cardiovascular function.
对22例开胸手术中接受单肺通气（OLV）的患者测定了总氧输送量（心输出量×动脉血氧含量）和氧耗量。11例患者用氟烷 - 氧气维持麻醉，另外11例患者用氧化亚氮 - 氧气 - 镇痛药组合（FIO2 0.5）维持麻醉。在OLV期间，氟烷组的氧输送量更高，与氧化亚氮组患者相比，这些患者的氧耗量有下降趋势。因此，就OLV期间的总氧平衡（氧输送量/氧耗量）而言，氟烷 - 氧气维持麻醉比氧化亚氮 - 氧气 - 镇痛药组合提供了更大的安全 margin。然而，尽管偶尔会出现低氧血症发作，但我们接受50%氧化亚氮吸氧的患者中，没有一例的氧输送系数（氧输送量/氧耗量）明显小于未麻醉患者的预测正常值。这一发现可能解释了为什么在心血管功能未受损的患者OLV期间使用这种麻醉技术没有明显危害。
