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目的 研究不同年龄组患儿静脉全麻期间PETCO2 分压和波形的变化规律及其临床意义。方法 在1~6岁和7~12岁不同眼科手术患儿中各随机选择48例,分别为L组(1~6岁)和H组(7~12 岁)。在自主呼吸静脉全麻下采用鼻氧管采气方法动态观察静脉全麻前、麻醉后15、30、45、60min呼气末二氧化碳PETCO2 分压和波形变化。结果 L组30min、H组45min PETCO2 分压明显升高,两组均可出现三类异常的CO2 波形,其中L组Ⅱ类波形发生率明显高于H组。结论 小儿眼科手术静脉全麻中容易出现呼吸功能减弱,呼吸道不通畅而导致CO2积蓄,低年龄组更为显著;鼻氧管PETCO2 监测可提高小儿眼科手术静脉全麻的安全性。
Objective To study the changes of PETCO2 partial pressure and waveform during intravenous anesthesia in children of different ages and their clinical significance. Methods Forty-eight randomly selected children aged 1 to 6 years and 7 to 12 years old under different ophthalmic surgeries were L group (1-6 years) and H group (7-12 years) respectively. In the spontaneous breathing venous anesthesia using nasal oxygen tube gas dynamic method before anesthesia intravenous anesthesia 15,30,45,60 min end-expiratory carbon dioxide PETCO2 partial pressure and waveform changes. Results The partial pressure of PETCO2 in group L increased significantly at 30 min in group L and 45 min in group H, and three types of abnormal CO2 wave appeared in both groups. The incidence of type Ⅱ waveform in group L was significantly higher than that in group H. Conclusion Intravenous general anesthesia in pediatric ophthalmic surgery prone to respiratory dysfunction, respiratory tract is not smooth and lead to the accumulation of CO2, low age group is more significant; nasopharyngeal PETCO2 monitoring can improve the safety of pediatric ophthalmic anesthesia.