Xue F, Luo L, Tong S, Liao X, Tang G, Deng X
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing.
Chin Med J (Engl). 1995 Jun;108(6):434-7.
One hundred and fifty-six children aged from 4 months to 12 years undergoing elective plastic surgery were included in this study. All children were ASA physical status I, under normal development, ranging from 64 to 140 cm in body height and from 6.0 to 41.0 kg in body weight. Following 2-minute preoxygenation, the time when SpO2 dropped to 95% and 90% in apneic period had a close correlation with age, weight and height of children by means of linear and non-linear regression analysis. The smaller the children's weight, the higher the incidence of severe arterial desaturation after reinstitution of manual ventilation with 100% oxygen at SpO2 of 90%. It is suggested that younger children are more susceptible to hypoxemia than older ones during apnea and provided no problem existing other than oxygen delivery, an SpO2 of 95% might be the safe limitation of apnea in pediatric anesthesia induction.
本研究纳入了156例年龄在4个月至12岁之间接受择期整形手术的儿童。所有儿童ASA身体状况均为I级，发育正常，身高64至140厘米，体重6.0至41.0千克。经过2分钟的预充氧后，通过线性和非线性回归分析，发现呼吸暂停期SpO2降至95%和90%的时间与儿童的年龄、体重和身高密切相关。儿童体重越小，在SpO2为90%时恢复100%氧气手动通气后严重动脉血氧饱和度降低的发生率越高。提示在呼吸暂停期间，年幼儿童比年长儿童更容易发生低氧血症，并且如果除了氧输送外不存在其他问题，SpO2为95%可能是小儿麻醉诱导中呼吸暂停的安全限度。
