Changes in oxygen supply-demand balance during induction of general anesthesia: an exploratory study using remimazolam.

IF 2.8 3区医学 Q2 ANESTHESIOLOGY Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-06-06 DOI:10.1007/s00540-024-03362-0

Kenya Yarimizu, Yu Onodera, Hiroto Suzuki, Masaki Nakane, Kaneyuki Kawamae

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Abstract

Purpose: This study was performed to evaluate the changes in oxygen supply-demand balance during induction of general anesthesia using an indirect calorimeter capable of measuring oxygen consumption (VO₂) and carbon dioxide production (VCO₂).

Methods: This study included patients scheduled for surgery in whom remimazolam was administered as a general anesthetic. VO₂ and VCO₂ were measured at different intervals: upon awakening (T1), 15 min after tracheal intubation (T2), and 1 h after T2 (T3). Oxygen delivery (DO₂) was calculated simultaneously with these measurements. VO₂ was ascertained using an indirect calorimeter and further calculated using vital signs, among other factors. DO₂ was derived from cardiac output and arterial blood gas analysis performed with an arterial pressure-based cardiac output measurement system.

Results: VO₂, VCO₂, and DO₂ decreased significantly from T1 to T2 and T3 [VO₂/body surface area (BSA) (ml/min/m²): T1, 130 (122-146); T2, 107 (83-139); T3, 97 (93-121); p = 0.011], [VCO₂/BSA (ml/min/m²): T1, 115 (105-129); T2, 90 (71-107); T3, 81 (69-101); p = 0.011], [DO₂/BSA (ml/min/m²): T1, 467 (395-582); T2, 347 (286-392); T3, 382 (238-414); p = 0.0020]. Among the study subjects, a subset exhibited minimal reduction in VCO₂. Although the respiratory frequency was titrated on the basis of end-tidal CO₂ levels, there was no significant difference between the groups.

Conclusion: General anesthetic induction with remimazolam decreased VO₂, VCO₂, and DO₂.

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全身麻醉诱导过程中氧气供需平衡的变化：使用雷马唑仑进行的探索性研究。

目的：本研究使用能够测量耗氧量（VO2）和二氧化碳产生量（VCO2）的间接热量计，评估全身麻醉诱导过程中氧气供需平衡的变化：本研究包括计划进行手术的患者，他们都使用了瑞马唑仑作为全身麻醉剂。VO2 和 VCO2 在不同时间段测量：苏醒时（T1）、气管插管后 15 分钟（T2）和 T2 后 1 小时（T3）。氧气输送量（DO2）与这些测量值同时计算。VO2 使用间接热量计确定，并通过生命体征等因素进一步计算。DO2 是通过基于动脉压的心输出量测量系统进行的心输出量和动脉血气分析得出的：结果：VO2、VCO2 和 DO2 从 T1 到 T2 和 T3 显著下降[VO2/体表面积（BSA）（毫升/分钟/平方米）：T1，130（122-146）；T2，107（83-139）；T3，97（93-121）；P = 0.011]，[VCO2/BSA（毫升/分钟/平方米）：T1，115（105-129）；T2，90（71-107）；T3，81（69-101）；P = 0.011]，[DO2/BSA（毫升/分钟/平方米）：T1，467（395-582）；T2，347（286-392）；T3，382（238-414）；P = 0.0020]。在研究对象中，有一部分人的 VCO2 下降幅度很小。虽然根据潮气末二氧化碳水平调整了呼吸频率，但各组之间并无显著差异：结论：使用瑞马唑仑进行全身麻醉诱导会降低 VO2、VCO2 和 DO2。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Anesthesia 医学-麻醉学

CiteScore

5.30

自引率

7.10%

发文量

112

审稿时长

3-8 weeks

期刊介绍： The Journal of Anesthesia is the official journal of the Japanese Society of Anesthesiologists. This journal publishes original articles, review articles, special articles, clinical reports, short communications, letters to the editor, and book and multimedia reviews. The editors welcome the submission of manuscripts devoted to anesthesia and related topics from any country of the world. Membership in the Society is not a prerequisite. The Journal of Anesthesia (JA) welcomes case reports that show unique cases in perioperative medicine, intensive care, emergency medicine, and pain management.