Xue F S, Tong S Y, Wang X L, Deng X M, An G
Department of Anesthesia, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing.
J Clin Anesth. 1995 Mar;7(2):93-6. doi: 10.1016/0952-8180(94)00011-r.
To determine the optimal length of preoxygenation in children.
Random design and comparison among groups.
Operating room of a plastic surgery hospital of the Chinese Academy of Medical Sciences and the Peking Union Medical College.
Forty healthy, ASA status 1 children (age 2 to 7 yrs), undergoing elective plastic surgery.
Children in Group 1 breathed 100% oxygen (O2) for 1 minute. Group 2 children breathed 100% O2 for 2 minutes. Group 3 and Group 4 children breathed 100% O2 for 3 minutes. Anesthesia was induced with midazolam 0.3 mg/kg, fentanyl 5 micrograms/kg. Muscle relaxation was achieved with vecuronium 0.1 mg/kg (Groups 1, 2, and 3) or succinylcholine 1.5 mg/kg (Group 4).
Oxygen saturation (SpO2) was measured by pulse oximeter. The oximeter probe was applied to the right big toe. After preoxygenation, the times for SpO2 to decrease to 98% (T98), 95% (T95), and 90% (T90), respectively, were recorded during the apneic period. T98, T95, and T90 were significantly shorter in Group 1 than in Group 2 or Group 3. There was no statistically significant difference among Groups 2, 3, or 4 regarding T98, T95, and T90. The times for SpO2 to decrease from 95% to 90% were similar among the four groups.
2 minutes of preoxygenation in children can provide the maximum benefit of denitrogenation and achieve 2 minutes of safe apea. 95% and 99% confidence intervals were 69 to 100 and 59 to 100, respectively. Succinylcholine had only a slight effect on the safe apneic period.
确定儿童预充氧的最佳时长。
随机设计及组间比较。
中国医学科学院整形外科医院及北京协和医学院的手术室。
40名健康的、美国麻醉医师协会（ASA）分级为1级的儿童（年龄2至7岁），接受择期整形手术。
第1组儿童吸入100%氧气（O₂）1分钟。第2组儿童吸入100% O₂ 2分钟。第3组和第4组儿童吸入100% O₂ 3分钟。使用咪达唑仑0.3 mg/kg、芬太尼5微克/千克诱导麻醉。第1、2和3组使用维库溴铵0.1 mg/kg（第4组使用琥珀酰胆碱1.5 mg/kg）实现肌肉松弛。
通过脉搏血氧仪测量血氧饱和度（SpO₂）。将血氧仪探头置于右大脚趾。预充氧后，记录在呼吸暂停期间SpO₂分别降至98%（T98）、95%（T95）和90%（T90）的时间。第1组的T98、T95和T90显著短于第2组或第3组。第2组与第3组或第4组在T98、T95和T90方面无统计学显著差异。四组中SpO₂从95%降至90%的时间相似。
儿童预充氧2分钟可提供最大的去氮效益，并实现2分钟的安全呼吸暂停。95%和99%置信区间分别为69至100和59至100。琥珀酰胆碱对安全呼吸暂停期仅有轻微影响。
