| Objective：This study observed the intraoperative PetCO2value and awakening in elderly patients with general anesthesiarecovery time and extubation time correlation and the safetyof intraoperative PetCO2value higher. Significance is clearintraoperative PetCO2value can be higher in elderly patientswith general anesthesia recovery period to promote patientsregained consciousness and respiratory recovery, shorten theresurgence of the elderly patients with general anesthesiarecovery time and extubation time, and reduce the resultingfrom the end tracheal tube indwelling restlessness, etc.Methods：Choose60cases of ASA level II～III, aged60～80,50～80kg weight, names of open surgery in patients withgeneral anesthesia, randomly divided into two groups, eachgroup30cases, high PetCO2group (group A) and normal PetCO2group (group B). Two groups of patients were all by intravenousanesthesia. Home to establish venous pathway, monitor ECG,blood pressure (SBP, DBP) and SpO2. Before anesthesia induction, awake with2%lidocaine local infiltration anesthesia lineradial artery puncture tube insertion. And continuouslymonitor invasive arterial pressure. After anesthesia inductionof intubation, constant speed infusion of propofol and fentanylmaintain anesthesia, intermittent intravenous fentanyl andatracurium. In5minutes after intubation, PetCO2valuestability after30minutes to reach the target range, sewingleather withdrawal when extracting arterial blood for blood gasanalysis determination of PH value and PaCO2, record PetCO2value at the same time. Intraoperative according to the initialvalues of PaCO2and PetCO2value and randomized to regulatebreathing rate and tidal volume that PetCO2target range. Forpatients with natural extubation after waking, observe andrecord two groups of the patient’s general condition; Home (T1),5minutes after intubation (T2), after reaching target PetCO2range30minutes (T3), sewing leather (T4) when the meanarterial pressure and heart rate of each point in time. T2, T3,T4PetCO2and PaCO2each time point; The awaken time andextubation time never put off till tomorrow what you can to;Postoperative Riker calm and agitation scale (SAS): commoncomplications after anesthesia.Results: Two groups of patients in the age, weight, operation time, anesthesia time, intraoperative blood loss,there was no statistically significant difference (P>0.05);Compare the T1～T4time point of mean arterial pressure andheart rate, there was no statistically significant difference(P>0.05); Preoperative arterial PH, PetCO2, PaO2and thecomparison of monitoring indicators, there was nostatistically significant difference (P>0.05); PetCO2andPaCO2good linear correlation; Awaken time and extubation timeof group A was significantly shorter than group B (P <0.05),round quality is much better than that of group A and group B;Postoperative sedation and agitation grade, there was nostatistically significant difference (P>0.05); The incidenceof postoperative nausea and vomiting, dizziness and drowsinessno statistical difference (P>0.05).Conclusion: In elderly patients with general anesthesia,intraoperative maintain high PetCO2value on general anesthesiarecovery time of spontaneous breathing recovery and stimulatesawakening, patients can shorten the awaken time and extubationtime, reduce recovery agitation caused by adverse reactions;This method will not cause cardiovascular system adverse events,had no obvious effect on circulation, the operation is safe;Patients recovery to good quality, do not increase the incidence of adverse reactions after anesthesia, and is of highmaneuverability. |
