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[采用连续吸气氧测量的闭合式系统麻醉(作者译)]

[Closed system anaesthesia with continuous inspiratory oxygen measurement (author's transl)].

作者信息

Spiess W

出版信息

Anaesthesist. 1977 Sep;26(9):503-13.

PMID:907086
Abstract

Relatively simple and inexpensive electrochemical oxygen-sensors have led to clinical evaluation of oxygen and nitrous oxide in completely closed circuits. Thus, a timely solution relating to possibilities of theatre-pollution and the economy this method allows, was obtained. "Fading" is a characteristic of electrochemical sensors; the principal factor involved seems to be the condensation of water vapor on the sensor, attenuating its sensitivity with the passage of time. However, a new model, that of Dräger, showed uniformly less than 1% fading after several hours of closed system anaesthesia, which is clinically negligible. Other failures were unmistakable and immediately recognizable. The techniques for neuroleptanalgesia and halothane anaesthesia with standard anaesthetic machines are described. The dosage of halothane with Vapor vaporizer, the reliability of absorption of CO2, the conditions which may be associated with accumulation of nitrogen up to 10 Vol.-%, as well as the relative merits of different ventilatores were explored. Studies performed with aid of oxygen sensors during clinical closed system anaesthetics are shown in relation to N2O-uptake and N2-elimination. In comparison with conventional methods the understanding of anaesthetic-uptake, the learning process and personal interest are enhanced, the patient's safety being ensured at the same time. The method of using a closed circuit here described was used in fifteen hundred patients ranging from 5-97 years without complications and is now routine at our clinic. Other advantages of the technique for the patient are retention of adequate humidification and heat of inspired gas and an almost complete dissociation of alveolar ventilation and uptake of anaesthetic.

摘要

相对简单且价格低廉的电化学氧传感器已用于完全封闭回路中氧气和一氧化二氮的临床评估。因此,找到了一个与手术室污染可能性及该方法所能带来的经济性相关的及时解决方案。“衰减”是电化学传感器的一个特性;其中涉及的主要因素似乎是水蒸气在传感器上的凝结,随着时间的推移会降低其灵敏度。然而,Draeger公司的一种新型号在封闭系统麻醉数小时后显示衰减均匀小于1%,这在临床上可忽略不计。其他故障则明显且易于立即识别。文中描述了使用标准麻醉机进行神经安定镇痛和氟烷麻醉的技术。探讨了使用Vapor蒸发器时氟烷的剂量、二氧化碳吸收的可靠性、可能与氮气积聚至10体积%相关的情况以及不同呼吸机的相对优点。展示了在临床封闭系统麻醉期间借助氧传感器进行的与氧化亚氮摄取和氮气消除相关的研究。与传统方法相比,对麻醉摄取的理解、学习过程和个人兴趣都得到了增强,同时确保了患者的安全。这里所描述的使用封闭回路的方法已应用于1500例年龄在5至97岁之间的患者,未出现并发症,现已成为我们诊所的常规方法。该技术对患者的其他优点包括保持吸入气体的充分湿化和热量,以及肺泡通气与麻醉剂摄取几乎完全分离。

相似文献

1
[Closed system anaesthesia with continuous inspiratory oxygen measurement (author's transl)].[采用连续吸气氧测量的闭合式系统麻醉(作者译)]
Anaesthesist. 1977 Sep;26(9):503-13.
2
[Anesthetic gas consumption and costs in a closed system with the PhysioFlex anesthesia equipment].[使用PhysioFlex麻醉设备的封闭系统中的麻醉气体消耗与成本]
Anaesthesist. 1993 Sep;42(9):638-43.
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[Efficiency of a mobile oxygen concentrator for mechanical ventilation in anesthesia. Studies with a metabolic lung model and early clinical results].[移动制氧机在麻醉机械通气中的效率。代谢肺模型研究及早期临床结果]
Anaesthesist. 1995 Sep;44(9):643-50.
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Clinical applications of low flow and closed circuit anesthesia.低流量及紧闭式麻醉的临床应用
Acta Anaesthesiol Belg. 1990;41(3):239-47.
5
[Respiratory gas exchange. Anesthesia with enflurane or isoflurane in nitrous oxide during spontaneous and controlled ventilation].[呼吸气体交换。在自主呼吸和控制呼吸时,在笑气中使用安氟醚或异氟醚进行麻醉]
Anaesthesist. 1993 May;42(5):273-9.
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[Anesthesia with the closed PhysioFlex system in comparison with conventional anesthesia procedures].[与传统麻醉程序相比,使用封闭式PhysioFlex系统进行麻醉]
Anaesthesiol Reanim. 1994;19(6):149-54.
7
[The closed system. A discredited conception of the past, by innovations the method of choice (author's transl)].[封闭系统。过去一个被摒弃的概念,因创新而成为首选方法(作者译)]
Anaesthesist. 1977 Aug;26(8):461-6.
8
[A comparative study of the cost of open-circuit as opposed to closed-circuit ventilation].开路通气与闭路通气成本的比较研究
Cah Anesthesiol. 1992;40(5):321-32.
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Inspired O2 and N2O concentrations in essentially closed circuits.基本封闭回路中的吸氧和氧化亚氮浓度
Anaesthesist. 1977 Sep;26(9):514-7.
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[Pulsed Brain-Spoerel system a new closed-circle system (author's transl)].[脉冲式脑-斯波雷尔系统——一种新型闭环系统(作者译)]
Anesth Analg (Paris). 1981;38(9-10):501-3.

引用本文的文献

1
Influence of the reference gas of paramagnetic oxygen analyzers on nitrogen concentrations during closed-circuit anesthesia.闭路麻醉期间顺磁氧分析仪的参比气对氮浓度的影响。
J Clin Monit Comput. 1998 Aug;14(6):381-4. doi: 10.1023/a:1009969219569.