预充紧闭程序麻醉

Programming Anesthesia with Priming in Closed System

回路内注药和铜壶挥发器紧闭程序麻醉,给药速率易控制,以往文献多采用。笔者实际测定Tec IV挥发器(Cyprane)在200～6000ml/min流最范围的稳态输出量,结果表明其实际输出浓度与相应标定刻度相关良好,并于近期为40例择期手术患者实施了预充紧闭程序麻醉。术前日取得病人某些最要生命参数并输入美国产IBM286兼容机(PC286),经运行自编程序(QIAP),计算并打印出各患者的氧耗量(VO_2/min)、氧化亚氮(N_2O)和挥发性麻醉药量(UD)等个体量化数据,供施麻醉者参考。术期多参数监测显示紧闭组呼末麻醉药浓度为1.29～1.37MAC。麻醉期间心率、血压等均在正常范围,无缺氧和CO_2蓄积,并可节省麻醉药,载气近80％～90％,减轻手术工作环境污染,安全可行,适合国内现状。

Many articles about programmmg inhalatiorr anesthesia by injecting the volatile agent into the circuit or us-ing a copper kettle vaporizer in circle in a closed system had been reported. The constant output of the Tec 4 va-porizer(Cyprane)with the fresh gas flow ranged from 200 to 6 000 ml/min had been measured. Results showed that its real output concentration had a good correlation with the dial settings. Programmmg anesthesia had been practised for 40 patients,who had to recieve selective operations.with primmg method m a closed system. Before operation,some important vital parameters of the patient were input to PC-286 mdividual computerCIBM USA). After performing quantitative inhalation anesthesia programme(QIAP) ,several individual quantitative data,such as oxygen consumption (VO2) , unit dose of both nitrous oxide (N2O) and volatile agent were calculated and printed out , which could be consulted by anesthesiologist. A lot of penoperative momtoring parameters revealed that total end expiratory concentration of both N-O and volatile agent was at 1. 29 to 1. 37 minimal alvealor concentration (M AC). Heart rate and blood pressure were at normal range during the operation. No hypoxia or hy-percapma was found. It was believed that the method taken was safe. It can diminish the air pollution m the the-atre and reduce drug wasting about 80%.