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The Effect of Different Ventilatory Pattern During Pre-oxygenation and Induction of Anaesthesia Upon Duration of Non-hypoxic Apnoea in Old Patients

Author: WangFeiXiang
Tutor: YanMin
School: Zhejiang University
Course: Anesthesiology
Keywords: End-expiratory pressure (PEEP) Continuous positive airway pressure (CPAP) No ventilation period Anesthesia, general
CLC: R614
Type: Master's thesis
Year: 2010
Downloads: 21
Quote: 0
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Abstract


Body in the process of induction of anesthesia, intubation operation due to the need ventilation, it is generally 100% oxygen oxygen to go the nitrogen ventilation in order to prolong the duration of non-hypoxic respiratory called security time limit. But some research has also confirmed that certain degree of atelectasis oxygenation and lung damage can occur within minutes after induction of anesthesia: inhalation of pure oxygen without inhaling pure oxygen in turn shorten the duration of non-hypoxic respiratory . In recent years, many domestic and foreign scholars have studied and reported on the different ways to improve the oxygenation status in the induction of general anesthesia, these studies are mostly seen in young adults, and fewer choose to compare the ventilation mode. This study in elderly patients with four different ventilation modes, the analysis of comparative elderly patients during anesthesia induction different ventilation modes on blood gas analysis, the duration of the intrapulmonary shunt fraction and non-hypoxic respiratory, choose the best for clinical The ventilation mode provides the theoretical and experimental basis. After obtaining the informed consent of patients, select ASA Ⅰ ~ Ⅱ grade, age greater than 65 years of age undergoing elective abdominal surgery, 60 cases of anesthesia in elderly patients were randomly divided into four groups, with 15 cases each. Before induction of anesthesia, so patients with head thrown back a little spontaneous breathing mask when the line pressure suction 100? 5 min, anesthesia was induced after the disappearance of the spontaneous breathing pure oxygen downstream mechanical ventilation modes 5min: group I: control group (mask under spontaneous breathing without CPAP, the normal capacity of intermittent positive pressure ventilation), II group, CPAP ventilation group of high-capacity, III group, CPAP PEEP group, Ⅳ group that CPAP IRV group. Intubation is completed and confirmed, positive pressure ventilation and catheter placed in the open state, connected with air, patients remain apnea state until SpO2 dropped to 90% and record the duration. Apnea in patients immediately before and right atrial blood gas analysis were performed arterial blood and jugular venous catheter collection. SpO2 dropped to 92%, and arterial blood gas analysis. The experimental results show Ⅲ group were compared with group Ⅰ, Ⅱ, non-hypoxic respiratory duration significantly longer (P lt; 0.05); the apnea immediately before PaO2 was significantly higher (P lt; 0.05); PA- aO2 significantly lower (P lt; 0.05). Ⅳ group were compared with group Ⅰ, Ⅱ, non-hypoxic respiratory duration significantly longer (P lt; 0.05); the the apnea immediately before PaO2 was significantly higher (P lt; 0.05); the PA-aO2 significantly reduced ( P lt; 0.05). Apnea immediately before Qs / Qt four groups there was no significant sex difference (P gt; 0.05). When SpO2 dropped to 92%, among the four groups PaO2 and PaCO2 was no significant difference (P gt; 0.05). The research results show that the induction of general anesthesia CPAP PEEP and CPAP IRV two ventilation modes can be significantly improved PaO2, reduce PA-aO2, more conducive to extend the duration of non-hypoxic breathing.

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