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

1. 应用质谱联用计算机系统对临床麻醉中两种吸入性麻醉剂（异氟醚和七氟醚）的吸收和消除情况进行了研究。虽然两种药物的摄取率随着时间的推移而下降，但肥胖患者的摄取率下降幅度小于非肥胖患者。肥胖患者肺泡麻醉浓度（F_A）随时间升高的速率比非肥胖患者缓慢。这些结果表明肥胖患者脂肪组织对挥发性麻醉药的吸收比非肥胖患者更活跃。吸入异氟醚时F_A/F_I随时间的上升速率小于吸入七氟醚时，这可能是由于两种药物的血/气分配系数不同所致。探讨肾上腺素溶液浸润口腔黏膜下组织对口腔手术患者耗氧量（VO_2）和产氧量（VCO_2）的影响。肾上腺素浸润使VO_2和VCO_2均升高，且这种作用至少持续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引起全身代谢增加所致。探讨低碳酸血症对临床麻醉中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患者的VO_2没有显著增加。

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.