过度通气正常二氧化碳分压的方式对促进异氟醚麻醉苏醒的有效性和安全性

发布时间：2018-05-18 04:30

本文选题：过度通气 + 二氧化碳　；参考：《临床麻醉学杂志》2015年05期

【摘要】：目的过度通气正常二氧化碳分压的方式对促进异氟醚麻醉苏醒的有效性和安全性。方法择期甲状腺手术患者32例。采用1 MAC异氟醚吸入复合瑞芬太尼持续静脉输注维持麻醉。进入苏醒期后随机分为两组:过度通气正常二氧化碳分压组(I组),在苏醒期采用正常二氧化碳(新鲜气流内加入适量CO2)过度通气策略,维持PETCO2为42~45mm Hg。对照组(C组)按传统方法增加新鲜气体流量(无CO2)加速麻醉药洗出。记录并比较两组关闭挥发器至BIS值75时间、睁眼时间和拔管时间。并观察不良反应发生情况。结果与C组比较,恢复期I组PETCO2、气道峰压明显升高(P0.01),I组BIS至75时间、BIS至95时间、睁眼时间、张口时间和拔管时间明显缩短(P0.01)。两组患者均未发生恶心、呕吐或寒战不良反应,仅I组2例患者出现术后烦躁,与C组比较差异无统计学意义。结论过度通气正常二氧化碳分压方式能够安全有效地加速异氟醚麻醉苏醒。
[Abstract]:Objective to improve the efficacy and safety of overventilation of normal carbon dioxide partial pressure in promoting isoflurane anesthesia recovery. Methods 32 patients with selective thyroid surgery were treated with 1 MAC isoflurane inhalation combined with remifentanil continuous intravenous infusion to maintain anesthesia. After the awakening period, two groups were randomly divided into hyperventilation normal carbon dioxide partial pressure group (I In the awakening period, the over ventilation strategy of normal carbon dioxide (CO2) was adopted in the fresh air flow, and PETCO2 was maintained for the 42~45mm Hg. control group (C group) to increase the fresh gas flow (without CO2) to accelerate the anaesthetic. The two groups were recorded and compared to the BIS value of 75, the opening time and the extubation time. Results compared with group C, the airway peak pressure in group I was higher than that of group C (P0.01), I group was BIS to 75 time, BIS to 95 time, opening time, opening time and extubation time significantly shortened (P0.01). The two groups had no nausea, vomiting or chill adverse reactions, only 2 patients in group I had postoperative irritability, and the difference was compared with C group. No significant difference was found. Conclusion hyperventilation and normal carbon dioxide partial pressure can effectively and safely accelerate the recovery of isoflurane anesthesia.
【作者单位】：北京市平谷区医院麻醉科;首都医科大学附属北京朝阳医院;
【分类号】：R614

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