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[呼吸功能与呼气末一氧化二氮浓度变化之间的关系]

[The relationship between respiratory function and the change in end-tidal nitrous oxide concentration].

作者信息

Tsuchiya M, Tokai H, Kataoka Y, Manabe M

机构信息

Department of Anesthesia, and Emergency and Critical Care Medicine, National Hospital Tokyo Disaster Medical Center, Tachikawa.

出版信息

Masui. 1998 Aug;47(8):987-91.

PMID:9753966
Abstract

The aim of the present study is to clarify the relationship between respiratory function and the rate of change in alveolar anesthetic concentration. We measured the concentration of end-tidal nitrous oxide (N2O) when 50% N2O was administered to 15 patients of ASA I possessing normal respiratory function during the course of propofol-100% oxygen anesthesia. All patients were ventilated at a rate of 8-10 ml.kg-1 x 8 times per minute using a conventional anesthetic ventilator with semi-closed circuit and 4 l.min-1 inflow of fresh gas. Arterial CO2 partial pressure was maintained at 36.2 +/- 1.8 mmHg and no significant circulatory change was observed while N2O was administered. The rate of increase of end-tidal N2O concentration in poor FEV1.0/FVC% group was significantly slower than that in high FEV1.0/FVC% group, while there was no relation between %VC and the end-tidal N2O concentration change. Since N2O is an inhaled anesthetic, it is well considered that the effect of FEV1.0/FVC% may be observed in other inhaled anesthetic although the magnitude of the effect may vary. The present result suggests that respiratory function, especially FEV1.0/FVC%, is an important factor affecting the rate of change in alveolar anesthetic concentration and, in lower FEV1.0/FVC% group, it takes more time to achieve the intended alveolar concentration.

摘要

本研究的目的是阐明呼吸功能与肺泡麻醉药浓度变化率之间的关系。我们在丙泊酚-100%氧气麻醉过程中,对15例呼吸功能正常的ASA I级患者给予50%氧化亚氮(N2O)时,测量了呼气末氧化亚氮(N2O)的浓度。所有患者均使用带有半封闭回路和4 L·min-1新鲜气体流入的传统麻醉呼吸机,以8 - 10 ml·kg-1×每分钟8次的速率进行通气。在给予N2O期间,动脉血二氧化碳分压维持在36.2±1.8 mmHg,未观察到明显的循环变化。FEV1.0/FVC%低的组中呼气末N2O浓度的增加速率明显慢于FEV1.0/FVC%高的组,而%VC与呼气末N2O浓度变化之间没有关系。由于N2O是一种吸入性麻醉药,尽管效果的程度可能不同,但可以合理地认为在其他吸入性麻醉药中也可能观察到FEV1.0/FVC%的影响。目前的结果表明,呼吸功能,尤其是FEV1.0/FVC%,是影响肺泡麻醉药浓度变化率的一个重要因素,在FEV1.0/FVC%较低的组中,达到预期肺泡浓度需要更多时间。

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