小儿麻醉诱导中无通气间期SpO_2安全阈值的研究小儿麻醉诱导中无通气间期SpO2安全阈值的研究

A Study on the Safe Threshold of Apneic Period in Pediatric Patients during Anesthesia Induction

１５２例ＡＳＡⅠ级行择期整形手术的小儿，根据年龄分成三组：Ⅰ组为３个月～１岁的婴儿（ｎ＝３９）；Ⅱ组为１～３岁的幼儿（ｎ＝４１）；Ⅲ组为３～１２岁的小儿（ｎ＝７２）。每组小儿再随机分成Ａ亚组和Ｂ亚组。监测ＳｐＯ２、血压、心率和ＰＥＴＣＯ２。预氧时间为２ｍｉｎ。在麻醉诱导后的无通气期，Ａ亚组和Ｂ亚组分别在ＳｐＯ２降至９０％和９５％时给氧。结果证实，小儿ＳｐＯ２降至９５％和９０％所需的无通气时间在三组间均具有明显差别。给氧后，Ａ亚组全部小儿的ＳｐＯ２降至９０％以下；而Ｂ亚组仅有２例（２．７％）小儿的ＳｐＯ２降至９０％以下。给氧后ＳｐＯ２降至的最低值在三组间及每组的Ａ亚组和Ｂ亚组间均有明显差别。因此小儿无通气间期ＳｐＯ２的安全阈值应建立在９５％。直线回归分析发现，无通气期ＳｐＯ２降至９５％所需时间与小儿年龄、体重和身高具有明显相关性。１５２例ＡＳＡⅠ级行择期整形手术的小儿，根据年龄分成三组：Ⅰ组为３个月～１岁的婴儿（ｎ＝３９）；Ⅱ组为１～３岁的幼儿（ｎ＝４１）；Ⅲ组为３～１２岁的小儿（ｎ＝７２）。每组小儿再随机分成Ａ亚组和Ｂ亚组。监测ＳｐＯ２、血压、心率和ＰＥＴＣＯ２。预氧时间为２ｍｉｎ。在麻醉诱导后的无通气期，?

Plastic Surgery Hospital, CAMS and PUMC, Beijing One hundred and fifty two infants and children, ASA grade I, scheduled for elective plastic surgery were inclueded in this study. Patients were divided into three groups by age: Group 1,infants aged from three months to 1 year(n=39); Group 2,children aged 1 to 3 years(n=41); and Group 3, children aged 3 to 12 years (n=72). Patients in each group were randomly allocated to subgroups A and B further. SpO 2, blood pressure, heart rate and P ET CO 2 were monitored throughout the observation. Preoxygenation was done for 2 minutes. Patients were manually ventilated when SpO 2 decreased to 90% in subgroups A and 95% in subgroups B respectively. Our results showed that there were significant differences in the apneic times for SpO 2 to decrease to 95% and 90% between the three groups. When artificial ventilation was given at SpO 2 of 90% in the subgroups A, SpO 2 continued to decrease to less than 90% in all children. After reinstitution of manual ventilation at SpO 2 of 95% in the subgroups B, the lowest SpO 2 of less than 90% only occurred in two patients (2 7%). Significant differences existed among the three groups and between subgroups A and B of each group in the lowest value of SpO 2 following apnea. It is concluded that the safe threshold of apneic period setting to SpO 2 of 95% is appropriate in pediatric patients during anesthesia induction. The apnea time to SpO 2 of 95% correlated well with childrens age, weight and height by linear regression analysis.