Effects of general anesthesia of sevoflurane inhalation on perioperative blood gas indicators in patients with mild-to-moderate chronic obstructive pulmonary disease / 中国基层医药

ABSTRACT

Objective:To explore the clinical effects of general anesthesia of sevoflurane inhalation in abdominal surgery for patients with mild-to-moderate chronic obstructive pulmonary disease (COPD).Methods:The clinical data of 68 patients with COPD abdominal surgery who admitted to the Department of Anesthesiology of Yiwu Central Hospital from June 2016 to June 2018 were retrospectively analyzed.According to the ratio of forced expiratory volume in 1 second in predicted value (FEV 1%pre), the patients were divided into mild group (FEV 1%pre≥80%, n=39) and moderate group (80%>FEV 1%pre≥50%, n=29). The blood gas indicators[arterial partial pressure of oxygen (PaO 2), arterial partial pressure of blood carbon dioxide (PaCO 2), blood oxygen saturation (SaO 2)], vital signs[heart rate (HR), mean arterial pressure (MAP)] and systemic vascular resistance (SVR) were compared between the two groups after entering (T0), after completion of induction (T1), at abdominal exploration (T2), before the end of surgery (T3) and after extubation (T4). The recovery quality indicators were analyzed in the two groups. Results:In the mild group at T1, T2 and T3, the PaO 2 values were (301.6±76.2)mmHg, (292.6±73.4)mmHg, (112.8±34.1)mmHg, respectively, and the SaO 2 values were (99.1±0.8)%, (98.8±1.0)%, (94.5±2.2)%, respectively, all of which were significantly improved compared with those at T0 ( t=23.51, 22.73, 12.34, 2.75, 2.93, 2.22, all P<0.05), while the PaCO 2 values were (40.5±9.3)mmHg, (40.2±9.1)mmHg, (43.7±7.9)mmHg, respectively, which were significantly decreased compared with those at T0 ( t=0.98, 1.12, 0.84, all P<0.05). The moderate group showed the same trend as the mild group, but there were no statistically significant differences between the two groups (all P>0.05). At T4, the PaO 2, PaCO 2 and SaO 2 levels in the two groups showed no significant changes compared with those at T0, and there was no statistically significant difference between the two groups at the same time (all P>0.05). At T1 and T2, the MAP levels in the mild group were (75.5±11.0)mmHg, (80.7±11.9)mmHg, respectively, the HR values were (71.4±12.5)times/min, (74.2±13.6)times/min, respectively, the SVR values were (9.1±1.6)×10 2 dynesos -1ocm -5, (9.9±2.0) ×10 2 dynesos -1ocm -5, which were significantly lower than those at T0 ( t=1.35, 0.95, 1.83, 0.64, 1.42, 0.27, all P<0.05). The moderate group showed the same trend as the mild group, but there were no statistically significant differences between the two groups (all P>0.05). At T3 and T4, there were no significant changes in levels of MAP, HR and SVR between the two groups compared with those at T0, and there were no significant significant differences between the two groups (all P>0.05). The spontaneous breathing time, duration of eye opening, time of fist, time of removing tracheal catheter and time of returning to the ward in the mild group were slightly shorter than those in the moderate group (all P>0.05). Conclusion:When general anesthesia of sevoflurane inhalation is used in abdominal surgery of COPD patients, the trend of blood gas indicators is not affected by COPD, which can provide reference for clinical establishment of anesthesia regimens.