摘要
目的 采用颈内静脉血氧饱和度监测技术 ,观察静脉全麻期间不同程度的过度通气对脑氧供需平衡状态的影响。方法 静脉全麻下开颅行幕上肿瘤切除术患者 6 6例 , 、 和 组分别维持 PETCO2 为 3.5、4.0和 4.5 k Pa,6 0分后同步采集动脉和颈内静脉球部血样。监测 Sjv O2 ,计算脑氧摄取 (CEO2 )和 C(a- jv) O2 。结果 组通气后 Sjv O2 和 Cjv O2 降低 ,CEO2 增高 ,且与其基础值和 、 组对应值比较有明显差异 (P<0 .0 5 ) ; 和 组通气后 Sjv O2 、Cjv O2 和 CEO2 、C(a- jv) O2 均无明显变化。结论 颅脑手术麻醉期间严重过度通气 (PETCO2 3.5 k Pa)可出现脑氧供需失衡 ,维持 PETCO2(4.0～ 4.5 ) k Pa认为是最适过度通气界限。
Objective To evaluate the effects of various degrees of hyperventilation on balance of cerebral oxygen supply and consumption during intravenous genaral anesthesia with jugular venous oxygen saturation monitoring.Methods Sixty six patients of supratentorial tumor undergoing intravenous general anesthesia and brain surgery were randomly divided into three groups.In group Ⅰ,Ⅱ and Ⅲ, P ET CO 2 were maintained at 3.5,4.0 and 4.5kPa respectively.Radial arterial blood samples and jugular bulb blood samples were taken synchronously 60 min following hyperventilation.Cerebral oxygen extraction rate (CEO 2)and C(a jv)O 2 were calculated.Results In group I following hyperventilation,SjvO 2 and CjvO 2 were decreased markedly,CEO 2 was increased significantly,which was differences significantly compared with the baseline and corresponding values in group Ⅱ and Ⅲ(P<0.05).During hyperventilation,in group Ⅱ and Ⅲ SjvO 2, CjvO 2,CEO 2 and C(a jv)O 2 remained unchanged.Conclusion Excessive hyperventilation(P ET CO 2 3.5kPa)may account for the less favorable balance of cerebral oxygen supply and consumption,maintaining P ET CO 2 at 4.0 4.5kPa is optimal hyperventilation for brain surgery anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1999年第2期78-80,共3页
Chinese Journal of Anesthesiology
