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

Autor: Yarimizu K; Department of Anesthesiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan. yarimizu.kenya@gmail.com., Onodera Y; Department of Anesthesiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan., Suzuki H; Yamagata City Miyuki Hospital, Yamagata, Japan., Nakane M; Department of Emergency and Critical Care Medicine, Yamagata University Hospital, Yamagata, Japan., Kawamae K; Ohta-Nishinouti Hospital, Fukushima, Japan.
Jazyk: angličtina
Zdroj: Journal of anesthesia [J Anesth] 2024 Oct; Vol. 38 (5), pp. 622-630. Date of Electronic Publication: 2024 Jun 06.
DOI: 10.1007/s00540-024-03362-0
Abstrakt: 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 (VO 2 ) and carbon dioxide production (VCO 2 ).
Methods: This study included patients scheduled for surgery in whom remimazolam was administered as a general anesthetic. VO 2 and VCO 2 were measured at different intervals: upon awakening (T1), 15 min after tracheal intubation (T2), and 1 h after T2 (T3). Oxygen delivery (DO 2 ) was calculated simultaneously with these measurements. VO 2 was ascertained using an indirect calorimeter and further calculated using vital signs, among other factors. DO 2 was derived from cardiac output and arterial blood gas analysis performed with an arterial pressure-based cardiac output measurement system.
Results: VO 2 , VCO 2 , and DO 2 decreased significantly from T1 to T2 and T3 [VO 2 /body surface area (BSA) (ml/min/m 2 ): T1, 130 (122-146); T2, 107 (83-139); T3, 97 (93-121); p = 0.011], [VCO 2 /BSA (ml/min/m 2 ): T1, 115 (105-129); T2, 90 (71-107); T3, 81 (69-101); p = 0.011], [DO 2 /BSA (ml/min/m 2 ): 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 VCO 2 . Although the respiratory frequency was titrated on the basis of end-tidal CO 2 levels, there was no significant difference between the groups.
Conclusion: General anesthetic induction with remimazolam decreased VO 2 , VCO 2 , and DO 2 .
(© 2024. The Author(s).)
Databáze: MEDLINE
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