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，以1%至5%浓度的蒸汽形式的麻醉剂被递送至患者。一旦外科手术已经完成并且不再施用麻醉剂，血液将吸入的麻醉剂从大脑运送到肺部，在那里它从身体呼出。 脑血流量和通气率越高，全身麻醉的效果被逆转得越快，病人醒来得越快。 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CO2浓度，从而增加了脑血流量，并增加了血液将麻醉剂从大脑运送到肺部的速度。该装置含有活性炭，可在麻醉剂蒸汽离开肺部时迅速吸收，以防止其被再次吸入。 我们在一项有9头猪的研究中对该器械进行了评价。当使用异氟烷时，它平均缩短了14.5分钟的唤醒时间，当使用七氟烷时，缩短了10.5分钟。在一项对12名异氟烷麻醉患者的临床研究中，该设备将苏醒时间缩短了9.8分钟。第一阶段提案包括优化设备设计的工程任务，设备可用性的人为因素测试和一半患者将使用再呼吸吸收器的临床研究。我们将通过要求麻醉师查看录像带（对器械的存在设盲）并标记恢复自主呼吸、自主睁眼、张口至口头命令和取出气管内导管的时间，来测量使用和不使用器械时唤醒时间的差异。预计再呼吸吸收器将使唤醒时间缩短至少8分钟。 我们将使用临床数据开发一个计算机模型的生理过程中所涉及的唤醒。我们将使用该模型来确定器械说明书中应包含的内容，以便临床医生最有效地使用器械。 使用再呼吸/吸收器装置来缩短吸入麻醉后的唤醒时间，可能会降低美国每年进行的2000万次全身麻醉手术的总成本。更短的唤醒时间可能会减少手术所需的总时间，并提高手术室工作人员的效率和医院设施的使用。