探索非心脏手术的个体患者的佛消耗和CO2排放,使用目标控制的佛给药系统
Yann Gricourt1, Guillaume Bibollet1, Mikael Perin1
1Division of Anesthesia Intensive Care, Pain and Emergency Medicine, IMAGINE, University of Montpellier, Nîmes University Hospital, UR-UM 107, Nîmes, France.
优化赛沃氨酸消耗是成本和环境的关键. 使用0.5L.min-1的新鲜气流 (FGF) 的终潮 (ET) 控制,可以显著降低麻醉期间的花使用和碳排放.
科学领域:
- 麻醉学 麻醉学
- 环境健康 环境健康
- 药物经济学 药物经济学
背景情况:
- 在麻醉期间减少sevoflurane消耗带来了经济和环境挑战.
- 优化麻醉气的使用对于可持续的医疗保健实践至关重要.
- 终潮 (ET) 控制提供了一种精确麻醉剂管理的方法.
研究的目的:
- 在大量非心脏外科手术中使用ET控制来分析sevoflurane消耗.
- 评估通风器设置,特别是新鲜气流 (FGF) 的影响,对sevoflurane的使用和碳足迹.
- 确定最佳的麻醉管理策略,以减少sevoflurane消耗.
主要方法:
- 通过使用Aisys CS2麻醉系统与Carestation Insight软件对3064个成人非心脏手术的回顾性分析.
- 自动记录了sevoflurane的消耗量和碳足迹.
- 小组分析检查了新鲜气流 (FGF) 速率 (0.5,0.8,1 L.min-1),初始的 ET 血氨酸目标和气道管理 (内管道输入管与喉口罩) 的影响.
主要成果:
- 中位数的sevoflurane消耗量为0.16 mL.min-1,其碳足迹为0.23 kgCO2eq.min-1.
- 与0.5 L.min-1 (P < 0.01) 相比,0.8或1.0 L.min-1的FGF显著增加了赛沃氨酸消耗和二氧化碳排放.
- 喉膜口罩的使用与更高的消耗有关,特别是超过120分钟的时间 (P < 0.01).
结论:
- 控制ET,以FGF目标为0.5L.min-1是减少塞沃氨酸消耗的最有效策略.
- 优化FGF对于最小化麻醉剂使用和环境影响至关重要.
- 麻醉管理策略应考虑气道类型和持续时间,以进一步降低赛沃兰的消耗.
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