Minoda Y, Oda T, Sagara M, Yoshimura N
Department of Anesthesiology, Kagoshima University School of Medicine.
Masui. 1993 Apr;42(4):511-4.
We examined the ventilation of patients whose faces were draped during facial surgery under local anesthesia. Ten patients who underwent eye surgery received hydroxyzine 25 mg and pentazocine 15 mg i.m. before local anesthesia. Arterial blood samples and end-tidal respiratory gases from nasal cannulae were collected at the following selected times: before draping their faces, 10 min, 30 min, 60 min after draping, and after the drapes were removed. Both arterial carbon dioxide tension (42 +/- 1 mmHg before draping and 46 +/- 1 mmHg at 10 min) and end-tidal carbon dioxide tension (33 +/- 2 mmHg before draping and 36 +/- 1 mmHg at 10 min) were elevated significantly after their faces were draped. Hypercapnea was completely eliminated by suctioning the expired gases. It is concluded that hypercapnea is inevitable during face or neck surgery under local anesthesia, and that the expired gases should be monitored and removed.
我们研究了在局部麻醉下进行面部手术时面部被覆盖的患者的通气情况。10例接受眼部手术的患者在局部麻醉前肌肉注射了25毫克羟嗪和15毫克喷他佐辛。在以下选定时间采集来自鼻插管的动脉血样和呼气末呼吸气体：面部覆盖前、覆盖后10分钟、30分钟、60分钟以及覆盖物移除后。面部覆盖后，动脉二氧化碳分压（覆盖前为42±1毫米汞柱，10分钟时为46±1毫米汞柱）和呼气末二氧化碳分压（覆盖前为33±2毫米汞柱，10分钟时为36±1毫米汞柱）均显著升高。通过抽吸呼出气体可完全消除高碳酸血症。结论是，局部麻醉下进行面部或颈部手术时高碳酸血症不可避免，应监测并清除呼出气体。
