经氧合器吸入气体麻醉剂对机体氧耗和心肺复苏的影响

THE EFFECTS OF INHALATION ANESTHESIA THROUGH OXYGENATOR ON OXYGEN COMSUMPTIUON AND CARDIO-PULMONARY RESUSCITATION

目的 探讨心内直视手术“快通道麻醉”方法。方法 对 6 8例体外循环心内直视手术的患者随机分为两组。试验组 34例 ,采用自行设计的经氧合器吸入异氟醚的方法进行麻醉 ;对照组34例 ,行常规大剂量芬太尼的方法进行静脉麻醉。观察其对机体单位体表面积氧耗量 (VO2 )、平均动脉压最高值 (PMAP)、动脉血氧饱和度 (SaO2 )和心肺复苏的影响 ,并统计病人的ICU监护时间、住院时间及住院费用 ,两组进行对比 ,评价其临床应用价值。结果 试验组和对照组之间VO2 、SaO2 、PMAP、住院时间、心肺复苏情况比较没有明显差异 (P >0 .0 5 ) ;苏醒时间、ICU监护时间、住院费用比较具有显著性差异 (P <0 .0 5或 0 .0 1)。结论 经氧合器吸入异氟醚的麻醉方法是一种麻醉平稳、安全可靠、能缩短病人苏醒时间 ,节省病人住院费用、简单易行的“快通道麻醉”方法。

Objective To experiment with the method of fast-track anesthesia in endocardial operation under direct vision.Methods Sixty-eight patients were randomly divided into the experimental group of 34 cases undergoing inhalation of isoflurane through the self-designed oxygenator and the contrast group of 34 cases receiving the routine large-dosage use of fentanyl through intravenous injection. The effects of the two methods on oxygen consumption, the highest value of average arterial pressure, the degree of blood oxygen saturation and the cardio-pulmonary resuscitation were observed .The monitoring time of patients in ICU, the hospitalization time and the hospitalization expenditure were statistically compared and analyzed.Results There existed no significant differences between the two groups in terms of oxygen consumption , arterial pressure, degree of blood oxygen saturation, hospitalization time, cardio-pulmonary functional recovery (P>0.05), while there existed remarkable difference in terms of the time of resuscitation ,the monitoring time in ICU and the hospitalization expenditure (P<0.05 or 0.01).Conclusion Isoflurane inhalation through our self-designed oxygenator can shorten the time of resuscitation and reduce the hospitalization expenditure in addition to its safety and reliability.