Karlsten R, Englesson S
Department of Anaesthesiology, University Hospital, Uppsala, Sweden.
Br J Anaesth. 1993 Apr;70(4):411-3. doi: 10.1093/bja/70.4.411.
We have examined the use of continuous positive airway pressure (CPAP) and apnoeic oxygenation for restoration of spontaneous breathing at the end of anaesthesia after controlled ventilation. We studied 45 adult patients without a history of acute or chronic respiratory disturbances. Anaesthesia was induced with thiopentone or propofol and maintained with nitrous oxide and enflurane in oxygen. The patients were normocapnic during artificial ventilation. At the end of surgery, the lungs were ventilated for 5 min with oxygen and then given a CPAP of 8 cm H2O. Spontaneous ventilation was regained after a mean of 5 min and an arterial blood sample was obtained at the third breath. All patients were well oxygenated (PO2 mean 43.5 kPa, range 21-76 kPa) when spontaneous ventilation started. The pH was close to 7.28 in most cases (mean 7.28, range 7.21-7.32), and PCO2 varied in the range 6.6-9.9 kPa (mean 7.9 kPa). It is concluded that the method is safe with regard to oxygenation and acid-base balance.
我们研究了在控制通气后麻醉结束时使用持续气道正压通气（CPAP）和无呼吸氧合来恢复自主呼吸的情况。我们研究了45例无急性或慢性呼吸紊乱病史的成年患者。用硫喷妥钠或丙泊酚诱导麻醉，并用氧化亚氮和异氟醚在氧气中维持麻醉。患者在人工通气期间维持正常碳酸血症。手术结束时，用氧气对肺进行5分钟通气，然后给予8厘米水柱的CPAP。平均5分钟后恢复自主通气，并在第三次呼吸时采集动脉血样本。当自主通气开始时，所有患者的氧合状况良好（动脉血氧分压平均43.5千帕，范围21 - 76千帕）。大多数情况下pH值接近7.28（平均7.28，范围7.21 - 7.32），二氧化碳分压在6.6 - 9.9千帕范围内变化（平均7.9千帕）。结论是该方法在氧合和酸碱平衡方面是安全的。
