REBREATHING ABSORBER TO SPEED EMERGENCE FROM ANESTHESIA

再呼吸吸收器可加速麻醉苏醒

• 批准号: 6933578
• 负责人: JOSEPH A ORR
• 金额: $ 9.71万
• 依托单位: AXON MEDICAL, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2006-03-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6933578
• 关键词: air filtration; anesthesia complication; anesthesiology; biomedical equipment development; charcoal; clinical biomedical equipment; clinical research; general anesthesia; human subject; inhalation anesthesia; patient oriented research

DESCRIPTION (provided by applicant): When general anesthesia is administered, anesthetics in the form of vapors are delivered to a patient in 1% to 5% concentrations. Once the surgical procedure has been completed and anesthesia is no longer administered, blood carries the inhaled anesthetic from the brain to the lungs where it is exhaled from the body. The higher the brain blood flow and the ventilation rate, the quicker the effects of the general anesthetic are reversed and the faster the patient wakes up. Axon Medical has developed a simple device to shorten the wake up time. The device's rebreathing hose indirectly increases the patient's arterial CO2 concentration thereby increasing brain blood flow and increasing the rate at which blood carries anesthetic agents from the brain to the lungs. The device contains activated charcoal that rapidly absorbs anesthetic vapor as it leaves the lungs to prevent it from being rebreathed. We evaluated the device in a study with nine pigs. It shortened wake up times by an average of 14.5 minutes when isoflurane was used and 10.5 minutes when sevoflurane was used. In a clinical study with 12 patients anesthetized with isoflurane, the device shortened emergence times by 9.8 minutes. The Phase I proposal includes an engineering task to optimize the device's design, a human factors test of device usability and a clinical study where half the patients will use the rebreathing absorber. We will measure differences in wake up times with and without the device by asking an anesthesiologist to review video tapes (blinded to the presence of the device) and mark the time to return of spontaneous breathing, spontaneous eye opening, mouth opening to verbal command, and removal of the endotracheal tube. It is expected that the rebreathing absorber will shorten the wake up time by at least eight minutes. We will use the clinical data to develop a computer model of the physiologic processes involved during wake up. We will use the model to determine what should be included in the device's instructions so that clinicians will use the device most effectively. Use of the rebreathing/absorber device to shorten wake up time after inhaled anesthesia could potentially reduce the overall cost of surgery in each of the 20 million general anesthetic procedures performed in the United States each year. Shorter wake up times might decrease the overall time needed for surgery and improve the efficiency of the operating room staff and the use of hospital facilities.

描述(由申请人提供)： 当实施全身麻醉时，麻醉剂以蒸气的形式以1%至5%的浓度输送给患者。一旦手术程序完成，不再进行麻醉，血液就会将吸入的麻醉剂从大脑带到肺部，然后从身体呼出。脑血流量和通气率越高，全身麻醉剂的作用就越快逆转，患者醒得越快。Axon Medical开发了一种简单的设备来缩短唤醒时间。该设备的再呼吸软管间接增加了患者的动脉二氧化碳浓度，从而增加了脑血流量，并增加了血液将麻醉剂从大脑输送到肺部的速度。该设备含有活性碳，当麻醉剂蒸汽离开肺部时，它会迅速吸收，以防止再次呼吸。我们在一项对9头猪的研究中对该设备进行了评估。在使用异氟醚时，唤醒时间平均缩短14.5分钟，在使用七氟醚时，平均缩短10.5分钟。在一项有12名患者使用异氟醚麻醉的临床研究中，该设备将苏醒时间缩短了9.8分钟。第一阶段的提案包括一项优化设备设计的工程任务，一项设备可用性的人为因素测试，以及一项临床研究，其中一半的患者将使用再呼吸吸入器。我们将通过让麻醉师查看录像带(对设备的存在视而不见)，并标记恢复自主呼吸、自发睁眼、张口接受口头命令和拔除气管导管的时间，来衡量使用和不使用该设备时唤醒时间的差异。预计再呼吸吸收装置将使唤醒时间缩短至少8分钟。我们将使用临床数据来开发一个唤醒过程中涉及的生理过程的计算机模型。我们将使用该模型来确定设备说明中应该包括哪些内容，以便临床医生能够最有效地使用该设备。使用再呼吸/吸收装置来缩短吸入麻醉后的苏醒时间，可能会降低美国每年进行的2000万例全身麻醉手术中的手术总成本。较短的唤醒时间可能会减少手术所需的总体时间，并提高手术室工作人员的效率和医院设施的使用。