Tsuchiya M, Tokai H, Kataoka Y, Manabe M
Department of Anesthesia, and Emergency and Critical Care Medicine, National Hospital Tokyo Disaster Medical Center, Tachikawa.
Masui. 1998 Aug;47(8):987-91.
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.
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。