七氟醚的临床应用.pptVIP

Slide I —8 手术时间很短，则停药时MGhe FG均没有平衡，此时，MG和FG继续摄取药物，使肺泡气的分压下降加速。 手术时间中等，则停药时MG已经平衡，而 FG还没有平衡，此时，MG向肺泡排放麻药，而FG继续摄取药物。 Figure 21-19?Solubility and duration of anesthesia affect the decrease in alveolar concentration on recovery and hence the time needed to recover from anesthesia. The time to tracheal extubation after anesthesia with anesthetics that have different solubilities illustrates these two aspects of recovery. The time to extubation is longer after anesthesia in children anesthetized with isoflurane (the more soluble anesthetic) than in those anesthetized with desflurane. In addition, the duration of anesthesia has less impact on the time to extubation after anesthesia with the less soluble desflurane because most of the desflurane is cleared at the lung (does not recirculate to delay recovery.)? (Data from Nordmann GR, Read JA, Sale SM, et?al: Emergence and recovery in children after desflurane and isoflurane anaesthesia: Effect of anaesthetic duration. Br J Anaesth 96:779-785, 2006.)  Figure 21-21?The time to decrease partial pressure in the alveoli or vessel-rich group by a certain fraction directly depends on several factors, primary among which are the solubility of the anesthetic and the duration of anesthesia. If a decrement of 60% is needed, little difference in time to recovery will be found for a comparison of isoflurane, sevoflurane, and desflurane. If an 80% decrement is needed to permit awakening, awakening from isoflurane will be delayed for progressively longer times as the duration of anesthesia is increased, but awakening from desflurane or sevoflurane will be minimally affected. If 90% of the anesthetic must be eliminated, awakening from both sevoflurane and isoflurane will be delayed more and more as the duration of anesthesia increases (isoflurane more than sevoflurane), but awakening from desflurane will be minimally affected. At a 92% decrement, the duration of anesthesia will also affect recovery from desflurane.? (Modified from Eger