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

1.使用质谱仪和计算机系统，研究了异氟醚和七氟醚两种吸入麻醉剂在临床麻醉中的摄取和排出。虽然这两种药物的摄取率随着时间的推移而下降，但肥胖者的摄取率下降的速度比非肥胖者的小。肥胖者的肺泡麻醉剂浓度(F_A)随时间的升高比非肥胖者缓慢。这些结果表明，肥胖患者的脂肪组织对挥发性麻醉剂的摄取比非肥胖患者更活跃。异氟醚吸入时F_A/F_I随时间增加的速率小于七氟醚吸入时F_A/F_I的上升速度，这可能是由于两种药剂的血/气分配系数不同所致。本文研究了肾上腺素溶液渗入口腔黏膜下组织对口腔手术患者氧耗量(VO2)和二氧化碳生成量(VCO2)的影响。肾上腺素渗透使VO_2和VCO_2均升高，并持续至少30分钟。推测肾上腺素渗透后VO_2和VCO_2的升高主要是由于肾上腺素诱导的全身代谢增加所致。在临床麻醉中观察低碳酸血症对VO2的影响。在异氟醚或七氟醚麻醉下，中等程度的低碳酸血症(PaCO_2=30 mm Hg)对VO_2无明显影响。

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.