监护性麻醉下经鼻咽通气管监测PETCO2与PaCO2的相关性

摘要

Objective To evaluate the correlation of end-tidal carbon dioxide ( PetCO2 ) measurements with the arterial carbon dioxide (PaCO2) in patients during monitored anesthesia care (MAC) in different fresh gas flow(FGF). Methods Twenty ASA I or II status patients undergoing elective segmental mastectomy under local and intravenous anesthesia were included in this study. After local and intravenous anesthesia, when the OAA/S was 2 or 3, RR 10-15 bpm, the nasopharyngeal airway was set and connected to a mainstream PetCO2 measuring instrument as well as the screwed pipe(picture 1-3), FGF 1 L/mia PetCO2 was recorded and arterial blood samples was taken for gas analysis. Then the FGF was adjusted to 1. 5 L/min or 2 L/min, PetCO2 and PaCO2 were recorded separately. Results According to different FGF 1 L/min, 1. 5 L/min, 2 L/min, the correlation coefficient r was 0.927, 0.925, 0.852 (F<0.01), respectively; Pa-ETCO2(mean SD) was (2. 7 ± 0. 9) mm Hg, (3. 5 ± 1. 1) mm Hg and (4. 5 ± 1. 1) mm Hg, respectively. There was no statistically difference between any of the two groups (P<0. 01). Conclusion PetCO2 is well correlated with PaCO2 in patients during MAC.%目的 研究监护性麻醉(MAC)患者不同新鲜气流量(FGF)下经鼻咽通气管监测PETCO2与PaCO2的相关性.方法 择期在MAC下行单纯乳腺区段切除术女性患者20例,ASA Ⅰ或Ⅱ级.患者入室后依次静脉给予咪达唑仑、舒芬太尼及丙泊酚,当OAA/S为2～3分、RR为10～15次/分时,测量经鼻翼至耳垂的距离,选择经左/右侧鼻孔置入鼻咽通气管(一般为ID 7～7.5 mm)达咽部,调整鼻咽通气管位置,使得PETCO2波形为方波,随后调整FGF为1 L/min,调整10 min后,记录此时的PETCO2及测量PaCO2.按以上方法,依次调整FGF至1.5、2 L/min,分别记录相应的PET CO2及PaCO2.结果 FGF为1、1.5、2 L/min时,PETCO2与PaCO2的相关系数分别为0.927、0.925、0.852(P＜0.01).结论 MAC下当OAA/S为2～3分,RR为10～15次/分时,采用鼻咽通气管保持FGF1～2 L/min,PETCO2与PaCO2显著相关.