開胸手術の新しい麻酔法　　ＨＦＪＶと胸部硬膜外麻酔の併用

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タイトル別名
  • New Anesthetic Approach with high Frequency Jet Ventilation for Open-Chest Surgery
  • HFJVと胸部硬膜外麻酔の併用

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High frequency jet ventilation (HFJV) was used to treat 11 patients for pneumonectomy and lobectomy. The epidural was used as part of the anesthetic technique in all cases where the catheter was inserted prior to induction. Anesthesia was induced with diazepam given intravenously and nitrous oxide, followed by pancuronium bromide. Endobronchial intubation was performed with double lumen tube. During maintenance, the patients were ventilated by HFJV (IDC, VS 600) at surgical side (Frequency of 100/min., Driving gas pressure 15psi, Inspiration time %: 50%) and IPPV at other side. Anesthesia was maintained with an oxygen/nitrous oxide and epidural anesthesia with 2% Mepibacaine. During anesthesia, no remarkable change were found with respect to arterial pressure and central venous pressure, and repeated blood gas analysis showed normocarbia and adequate oxygen tension in spite of compression of the exposed lung. With the compression of lung, surgeons could proceed smoothly procedures. In postoperative recovery, as soon as nitrous oxide had been discontinued, patients awaked and were able to take deep breaths without chest pain. This study has demonstrated that, with open chest, HFJV could provid efficient aeraion and ventilation, and optimal condition for surgeous.

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