The P_ETCO₂Differences For Thoracotomy Surgeries In Different Lateral Position With Application Of AIMS

Objective: by looking up the anesthesia notes and medical sheets of193patients undergoing thoracotomy in left or right lateral position, with theapplication of anesthesia information management system （AIMS）, toinvestigate the P_ETCO₂differences between different lateral positions, as whileas the significance and feasibility of the application of computer AIMS inmedical research.Method: Looking up by using the anesthesia information managementsystem,193patients undergoing thoracotomy are divided into2groupsaccording to left or right lateral positions. After entering operating room, ECG、HR、SpO2、BP are monitoring as routine. After preoxygenation, patients wereperformed induced general anesthesia by intravenous injection with midazolam0.02-0.04mg·kg^-1、 fentanyl2³ug·kg^-1、 atracurium0.15mg·kg^-1andetomidate0.3mg·kg^-1in turn. Double-lumen bronchial catheter endotrachealintubation is followed by mechanical ventilation. Prime setting: breathing rate（f）=12times·min^-1, VT=8-10mL·kg^-1, fresh gas flow=2.0L·min^-1.10to15min after induction of general anesthesia, patients are repositioned in left orright lateral position, set in single lung ventilation and perform the surgeries.Adjusting f and VT according to SpO₂and P_ETCO₂，to maintain SpO₂98%～100%. Maintenance of anesthesia is that propofol（6-9mg/kg/h）andremifentanil （10-15μg/kg/h） was intravenous infusion to maintain anesthesia,atracurium is used only once in anesthesia induction and should not beadministrated in the operating progress.Totally99cases are in left group, and94in right group. All patients weremaintained the same lateral position during the surgery, after surgery, patients were restored to the supine position, extubation after regained consciousness.Routine vital signs were monitored by Philips MP50monitors, and anesthesianotes were recorded by DoCare AIMS running on the computers connected tothese monitors.During the research, all anesthesia notes and medical sheets weresearched and indexed with the built-in index module of DoCare AIMS. At thetime points of the surgery started （T₀）、10min\20min\30min\60min after（T1toT₄） and5min before the end （T₅）,6P_ETCO₂values were recorded, inputted intoMicrosoft Excel and saved as files. Statistical treatment is completed withSPSS18.0package. Measurement data is expressed by mean（X）±standarddeviation（s）, count data using t and χ2test, P<0.05is considered as statisticalsignificance.Result:1. The differences of in-surgery P_ETCO₂between different lateral positions:as the surgery continues, the P_ETCO₂in both groups shows increasingtendency;30min after the surgery began, P_ETCO₂shows differences in twogroups, and higher in right group.2. The significance and feasibility of the application of computeranesthesia information management system in medical research: thisresearch shows the application of computer AIMS combined with digitalmedical records system in medial researches is feasible, and the using ofcomputer software and man-machine interactive interface can lead toimprove the efficiency of the filtration and documentation, and gives theconvenience to researchers when collecting these data.Conclusion:1. In-surgery P_ETCO₂shows differences between left and right lateralpositions in this research.2. The research shows great significance and feasibility by the application of computer anesthesia information management system.