Igarashi M, Nakae Y, Ichimiya N, Watanabe H, Iwasaki H, Namiki A
Department of Anesthesiology, Sapporo Medical College.
Masui. 1993 Feb;42(2):249-54.
Many anesthesiologists are now interested in low flow, closed circuit anesthesia from an economical and environmental point of view. In order to evaluate clinically a newly developed electronically controlled anesthesia machine Engström's ELSA, we compared low flow, closed circuit anesthesia on 38 ASA I-II patients using ELSA, with high flow anesthesia on 12 ASA I-II patients using a conventional anesthesia machine. The results were as follows; 1. We could perform safe and economical low flow, closed circuit anesthesia using ELSA's injection vaporizer and accurate monitoring devices for O2, N2O, CO2 and concentrations of various volatile anesthetic agents. 2. Under low flow anesthesia, isoflurane consumption was 5.3 +/- 1.1 ml.h-1 x Vol.%-1 (mean +/- SE) with ELSA, which is about one fourth of the high flow anesthesia consumption (22.6 +/- 2.1 ml.h-1 x Vol.%-1 (mean +/- SE). 3. Low flow closed circuit anesthesia could maintain significantly higher temperature and humidity compared with high flow anesthesia. 4. Under low flow anesthesia of more than 7hrs, color of soda lime becomes blue, but this does not affect FIO2 nor PaCO2, and the method is clinically safe for patients.
从经济和环境角度来看,许多麻醉医生现在对低流量紧闭式麻醉感兴趣。为了临床评估新开发的电子控制麻醉机恩斯特龙ELSA,我们将38例ASA I-II级患者使用ELSA进行的低流量紧闭式麻醉,与12例ASA I-II级患者使用传统麻醉机进行的高流量麻醉进行了比较。结果如下:1. 使用ELSA的注射蒸发器以及用于氧气、氧化亚氮、二氧化碳和各种挥发性麻醉剂浓度的精确监测设备,我们能够实施安全且经济的低流量紧闭式麻醉。2. 在低流量麻醉下,使用ELSA时异氟烷的消耗量为5.3±1.1 ml·h⁻¹×Vol.%⁻¹(平均值±标准误),约为高流量麻醉消耗量(22.6±2.1 ml·h⁻¹×Vol.%⁻¹(平均值±标准误))的四分之一。3. 与高流量麻醉相比,低流量紧闭式麻醉能显著维持更高的体温和湿度。4. 在超过7小时的低流量麻醉下,碱石灰会变蓝,但这并不影响动脉血氧分压(FIO2)和动脉血二氧化碳分压(PaCO2),该方法对患者临床安全。