Intravenous anesthesia


Anesthesia and Pain Medicine. 2006 June 10(2): 60-68
ⓒ Korean Society for Intravenous Anesthesia
Change of Arterial Blood Gas and Static Compliance Depend upon Variations of Tidal Volume in Gastrectomy Patients with General Anesthesia
Ho Sun Jang, M.D., Hee Koo Yoo, M.D., Gurn Seung Lee, M.D., Mi Ae Cheong, M.D., and Jong Hun Jun, M.D.
Department of Anesthesia and Pain Medicine, College of Medicine, Hanyang University Hospital, Seoul, Korea

Background: We sought to determine the immediate effects of specific tidal volume-PEEP combination upon oxygenation and static compliance in gastrectomy patients with general anesthesia. Methods: Fifty patients with general anesthesia for gastrectomy were enrolled in this study. Respiratory conditions were classified by variations of tidal volume (VT) and respiratory frequency (Rf) as A, B, C, D. VT and Rf for each of them were the same as A: 10 ml/kg, 9/min; B: 8 ml/kg, 11/min; C: 6 ml/kg, 13/min; D: 6 ml/kg, 13/min ⁢ 5 cmH2O PEEP. They were treated with respiratory conditions of A, B, C, D in alphabet order. At 45 minutes after each change of VT and Rf, arterial blood gas analysis, PaO2/FiO2, and static compliance were recorded. Results: When 6 ml/kg ⁢ 5 cmH2O PEEP compared with 10 ml/kg VT, PaO2 significantly improved to 242.08 ⁑ 33.60 mmHg (P < 0.05). Decreasing VT from 10 ml/kg to 8 ml/kg, 6 ml/kg, and 6 ml/kg ⁢ 5 cmH2O PEEP in this order, resulted in a increase in PaCO2 from 28.19 ⁑ 2.76 to 28.54 ⁑ 4.43, 31.52 ⁑ 5.24 (P < 0.05), and 32.84 ⁑ 6.04 mmHg (P < 0.05). Decreasing VT from 10 ml/kg to 8 and 6 ml/kg resulted in a significant decrease in peak pressure and at that time, static compliance was changed significantly decreasing from 49.10 ⁑ 10.83 to 43.42 ⁑ 8.52 (P < 0.05), 37.88 ⁑ 7.43 ml/cmH2O (P < 0.05) and significantly increasing to 52.69 ⁑ 15.48 ml/cmH2O (P < 0.05) with 6 ml/kg ⁢ 5 cmH2O PEEP. Conclusions: We suggest that 8 ml/kg for VT during anesthesia for gastrectomy is the best among 4 kinds of respiratory conditions.
Key words : arterial blood gas analysis, gastrectomy, mechanical ventilation, PEEP, static compliance, tidal volume.
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