不同年龄小儿眼科手术静脉全麻P_(ET)CO_2的变化

The Changes of Waveform and Value of P_(ET) CO_2 in Children of Different Age During Ophthalmic Surgery under Intravenous Anesthesia

目的:研究不同年龄组患儿静脉全麻期间PETCO2 分压及波形的变化规律及其临床意义。方法:随机选择眼科手术患儿96例,分为L组(1～6岁)和H组(7～12岁)。保留自主呼吸经鼻氧管采气方法,动态观察静脉全麻前、麻醉后15 min、30 min、4 5 min、6 0 min呼气末二氧化碳(PETCO2 )分压及波形变化。结果:L组30 min、H组4 5 min PETCO2 分压明显升高,两组均可出现3类异常的CO2 波形,其中L组 类波形发生率明显高于H组。结论:小儿眼科手术静脉全麻中容易出现呼吸功能减弱,呼吸道不通畅而导致CO2 积蓄可能,低年龄组更为显著;经鼻PETCO2 监测可提高小儿眼科手术静脉全麻的安全性。

Objective:To study the changes of waveform and value of P_ ET CO_2 in children of different age during ophthalmic surgery under total intravenous anesthesia (TIVA).Methods:96 children scheduled for ophthalmic surgery were divided into lower age of 1～6(L group) and hight age of 7～12(H group), 48 cases in each group. The changes of waveform and value of P_ ET CO_2 under TIVA and spontaneously breathing were monitored through a nasal side stream method in two groups.Results:P_ ET CO_2 showed significant increase 30 min and 45 min after anesthesia in L group and H group respectively. The P_ ET CO_2 waveform showed three abnormal types with high occurrence in two groups, while the occurrence of typeⅡabnormal waveform were significant higher in L group than that in H group.Conclusion:CO_2 accumulation was a common complication due to respiratory depression and respiratory tract obstruction in pediatric surgery under TIVA, and more serious in childern who were lower than 6 years old. P_ ET CO_2 monitoring by nasal side stream method could improve the safety for children during ophthalmic surgery under total intravenous anesthesia (TIVA).