体重指数对患者耐受呼吸暂停安全时限的影响

Effects of body mass index of patients on duration of non-hypoxic apnoea

目的:探讨全麻诱导插管期间,体重指数对患者呼吸暂停安全时限的影响。方法:选择年龄21～63岁,ASAⅠ-Ⅱ级择期手术的全麻病人80例。根据其体重指数(Body mass index,BMI)分为Ⅰ组(正常体重组)20例、Ⅱ组(超重组)20例、Ⅲ组(1°肥胖组)20例和Ⅳ组(2°肥胖组)20例。常规静脉麻醉诱导,诱导期间以10L/min的氧流量充分吸氧去氮4min,诱导结束行气管插管,插管完毕后继续脱氧观察,待脉搏氧饱和度(SpO2)降至90%时,接入麻醉机呼吸回路行控制呼吸。记录麻醉诱导末到SpO2下降至90%时的呼吸暂停时限,采集入室初、吸氧去氮后和SpO2降至90%时3个时间点的动脉血作血气分析。结果:各组患者呼吸暂停安全时限明显不同,其时限分别为(542.47±48.24)s(Ⅰ组)、(465.77±32.20)s(Ⅱ组)、(355.13±44.36)s(Ⅲ组)、(227.53±34.23)s(Ⅳ组),组间比较具有显著性差异(P<0.05)。结论:体重指数不同,患者耐受呼吸暂停时限明显不同,随着体重指数的增加,患者耐受呼吸暂停的时限逐渐缩短。

Objective：To investigate the effects ofbody mass index on duration of non-hypoxic apnoea during induction and intubation of anesthesia.Methods：80 patients undergoing surgery with general anaesthesia aged 21～63 years old with ASA Ⅰ-Ⅱgrade and without special diseases were included.they were assigned to one of four groups according to body mass index：Group 1（normal,n=20）,Group 2 （overweight,n=20）,Group 3（Ⅰ° obesity,n=20）and Group 4（Ⅱ°obesity,n=20）.Preoxygenation was achieved with an oxygen flowof10 litre/min within 4 minutes.After rapid sequence induction of anaesthesia,the trachea was intubated and the patient was left apneic with disconnected from the anaesthesia circuit until SpO2 decreased to 90%.The time taken for desaturation to 90%from the end of induction of anaesthesia was recorded.Arterial blood samples were drawn when patients to enter the operating room and the end of induction of anaesthesia and SpO2 decreased to 90%respectively for arterial blood ga（sABG）analysis.Results：Desaturation safety period（the time to desaturation to 90%）were significantly differences between four groups with different body mass index（P0.05）.The time were （542.47±48.24）（sGroup 1）,（465.77±32.20）（sGroup 2）,（355.13±44.36）（sGroup 3）,（227.53±34.23）s（Group 4）.Conclusion： Different body mass index of patients results in different desaturation safety period and potency of tolerance to apnoea.With the body mass index of patients increasing,the desaturation safety period become shorter and shorter.