開発途上国においてホース式リザーバー付きディスポーザブル蘇生バックを使用した麻酔経験

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  • Usefulness of disposable bag-valve resuscitator (PLUMANEX) during general anesthesia in developing countries

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In the developing countries, the poor supplies of oxygen, anesthetic gas and electric power make it difficult to anesthetize patients in the ordinary fashion.<br>In our past medical activities in Nepal and Cambodia, we practiced intravenous balanced anesthesia technique with air, oxygen and manual bag ventilation.<br>In this report, we compare three relatively simple respiratory devices such as Ambu-bagTM. Jackson -Rees circuit, and disposable bag-valve resuscitator to maintain artificial ventilation during balanced general anesthesia. We measured the level of patient end tidal CO2 (ETCO2), inspired oxygen concentration (FiO2), peripheral oxygen saturation (SpO2) and the required oxygen volume during anesthesia. Only SpO2 was maintained at a desirable level in all devices, but high ETCO2, unstable FiO2 and a high required oxygen volume was observed in the Jackson-Rees circuit. Respiratory accidents, such as dislocation or kinking of the respiratory circuit, were detected more easily in the disposable bag-valve resuscitator than in Ambu-bagTM due to the softness of the bag of the former.<br>We concluded that disposable bag-valve resuscitators are an excellent device for the management of general anesthesia in developing countries.

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