Perkins R, Meakin G
Department of Anaesthesia, Royal Manchester Children's Hospital, Pendlebury.
Anaesthesia. 1996 Dec;51(12):1089-92. doi: 10.1111/j.1365-2044.1996.tb15038.x.
We have measured the consumption of isoflurane and fresh gas flows in 77 infants and children during 20 all-day operating sessions using either the enclosed Mapleson A or the circle absorber mode of the Carden 'Ventmasta' ventilator. The average consumption (SD) of isoflurane in 37 patients anaesthetised using the A mode of the Carden system with a mean fresh gas flow of 2.61 min-1 was 11.1 (4.2) g.h-1, while that in 40 patients anaesthetised using the circle absorber mode with a mean fresh gas flow of 1.21 min-1 was 4.7 (1.0) g.h-1. These figures represent an overall saving of 58% in the use of isoflurane (p < 0.0001) and a mean reduction in fresh gas flow of 54% (p < 0.0001) as a result of using low-flow anaesthesia. With the addition of small bore breathing hoses the adult circle absorber system was practical to use in both infants and children. These findings should stimulate interest in the use of low-flow techniques in children.
我们在20次全天手术过程中，使用封闭的Mapleson A回路或Carden “Ventmasta” 呼吸机的循环吸收器模式，测量了77例婴幼儿和儿童的异氟烷消耗量及新鲜气体流量。在使用Carden系统A模式、平均新鲜气体流量为2.6 l·min⁻¹的37例麻醉患者中，异氟烷的平均消耗量（标准差）为11.1（4.2）g·h⁻¹；而在使用循环吸收器模式、平均新鲜气体流量为1.2 l·min⁻¹的40例麻醉患者中，异氟烷的平均消耗量为4.7（1.0）g·h⁻¹。这些数据表明，由于采用低流量麻醉技术，异氟烷的使用量总体节省了58%（p < 0.0001），新鲜气体流量平均减少了54%（p < 0.0001）。增加小口径呼吸软管后，成人循环吸收器系统在婴幼儿和儿童中都切实可行。这些发现应会激发人们对在儿童中使用低流量技术的兴趣。
