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A computerizing control system for evaluating respiratory, circulatory and metabolic states of surgical patients under general anesthesia

用于评估全身麻醉下手术患者呼吸、循环和代谢状态的计算机控制系统

基本信息

批准号：
04404062
负责人：
OKADA Kazuo
金额：
$ 17.92万
依托单位：
UNIVERSITY OF TEIKYO MEDICAL SCHOOL
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1992
资助国家：
日本
起止时间：
1992 至 1994
项目状态：
已结题

项目摘要

1. Using a mass-spectrometer in combination with a computer system, uptake and elimination of two inhalational anesthetic agents (isoflurane and sevoflurane) were investigated in clinical anesthesia. Although the rate of uptake of the two agents decreased with time, the rate of decrease in uptake was smaller in obese patients than in non-obese patients. The rate of rise with time in alveolar concentration of anesthetic ( F_A ) was more gradual in obese patients than in non-obese patients. These results suggest that uptake of volatile anesthetics by adipose tissues was more active in obese patients than in non-obese patients. The fact that the rate of rise in F_A/F_I with time during isoflurane inhalation was smaller than during sevoflurane inhalation might have resulted from a difference in blood/gas partition coefficient between two agents.2. The effect of infiltration of epinephrine solution into oral submucosal tissues on oxygen consumption ( VO_2) and CO_2 production ( VCO_2 ) was studied in patients scheduled for oral surgery. The epinephrine infiltration produced increases in both VO_2 and VCO_2 and these effect persisted for at least 30 minutes. It is assumed that the increases in both VO_2 and VCO_2 after epinephrine infiltration were mainly due to an increase in systemic metabolism induced by epinephrine.3. Effect of hypocapnia on VO_2 was investigated in clinical anesthesia. A moderate degree of hypocapnia ( PaCO_2 = 30 mmHg ) did not produce a significant increase in VO_2 in patients under isoflurane or sevoflurane anesthesia.

1.应用质谱仪结合计算机系统，研究了临床麻醉中两种吸入麻醉药（异氟醚和七氟醚）的摄取和消除。虽然两种药物的摄取率随时间降低，但肥胖患者的摄取率降低幅度小于非肥胖患者。肥胖患者肺泡麻醉药浓度（FA）随时间的上升速率比非肥胖患者缓慢。这些结果表明，脂肪组织对挥发性麻醉药的摄取在肥胖患者中比在非肥胖患者中更活跃。异氟醚吸入时F_A/F_I随时间的上升速率小于七氟醚吸入时，这可能是由于两种药物之间的血/气分配系数不同所致.本文研究了口腔手术病人口腔粘膜下浸润肾上腺素溶液对氧耗量（VO_2）和二氧化碳（VCO_2）的影响。肾上腺素浸润引起VO_2和VCO_2增加，这种作用至少持续30分钟。推测肾上腺素浸润后VO_2和VCO_2的增加主要是由于肾上腺素诱导的全身代谢增加。本文探讨了临床麻醉中低碳酸血症对VO_2的影响。中度低碳酸血症（PaCO_2 = 30 mmHg）对异氟醚或七氟醚麻醉的患者VO_2无明显增加。