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