1999 Fiscal Year Final Research Report Summary
EFFECTS OF PERIOPERATIVE APNEIC EPISODES ON ARTERIAL OXYGEN SATURATION AND HEMODYNAMICS IN GERIATRIC PATIENTS
| Project/Area Number |
10671445
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Teikyo University |
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Principal Investigator |
INADA Eiichi TEIKYO UNIVERSITY MEDICAL SCHOOL, DEPARTMENT OF ANESTHESIOLOGY, PROFESSOR, 医学部, 教授 (40193552)
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| Co-Investigator(Kenkyū-buntansha) |
OHNO Taro TEIKYO UNIVERSITY MEDICAL SCHOOL, DEPARTMENT OF ANESTHESIOLOGY, ASSISTANT, 医学部, 助手 (40266292)
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| Project Period (FY) |
1998 – 1999
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| Keywords | SPINALA ANESTHESIA / EPIDURAL ANESTHESIA / APNEA / MIDAZOLAM / PORPOFOL / HYPOXEMIA / CONTINUOUS POSITIVE AIRWAY PRESSURE / GERIATRIC PATIENT |
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| Research Abstract |
PATIENTS UNDERGOING ELECTIVE LOWER ABDOMINAL OR LOWER EXTREMITY SURGERY UNDER REGIONAL ANESTHESIA STUDIED. CONTROL GROUP WAS CONSTITUED OF ADULATS AGE BELOW 65 YEARS OLD UNDERGOING THE SIMILAR SURGERY UNDER REGIONAL ANESTHESIA. AIRFLOW, CHEST MOVEMENT, PERCUTANEOUS OXYGEN SATURATION, HEART RATE, AND BLOOD PRESSURE WERE MEASURED DURING STUDY PERIOD.
CONTROL GROUP PATIENTS EITHER AGE BELOW 65 OR AGE EQUAL TO OR AGE OVER 65 HAD RARE EPISODES OF APNEIC EPISODES UNDER SPINAL ANESTHESIA. GERIATRIC PATIENTS (MEAN AGE OF 74.6 YEARS OLD) UNDER SPINAL ANESTHESIA HAD FREQUENT EPISODES OF OBSTRUCTIVE APNEA WITHIN 90 MINUTES AFTER ONLY 0.014±0.022 MG/KG (RANGE 0.5-1.5 MG) OF MIDAZOLAM. THESE APNEIC EPISODES WERE ASSOCIATED WITH HYPOXEMIA. HALF OF THE PATIENTS HAD THE LOWEST OXYGYEN SATURATION BELOW 90%. THESE APNEIC AND HYOXIC EPISODES WERE NOT ASSOCIATED WITH HEMODYNAMIC CHANGES.
CONTROL PATIENTS CONTROL GROUP PATIENTS EITHER AGE BELOW 65 OR AGE EQUAL TO OR AGE OVER 65 HAD RARE EPISODES OF APNEIC EP
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ISODES UNDER EPIDURAL ANESYHESIA. ADULT PATIENTS UNDER EPIDURAL ANESTHSIA SEDATED WITH PROPOFOL INFUSION AT 2 MG/KG/HR HAD NO EPISODES OF OBSTRUCTIVE APNEA. HOWEVER, GERIATRIC PATIENTS (MEAN AGE OF 74.1 YEARS OLD) UNDER EPIDURAL ANESTHESA SEDATED WITH PROPOFOL INFUTION AT THE SAME RATE HAD MORE FREQUENT EPISODES OF OBSTRUCTIVE APNEA ASSOCIATED WITH OXYGEN DESATURATION. ONE-THIRD OF THE PATINS HAD THE LOWEST OXYGYEN SATURATION BELOW 90%. THESE APNEIC AND HYOXIC EPISODES WERE NOT ASSOCIATED DESATURATION. ONE-THIRD OF THE PATINES HAD THE LOWEST OXYGYEN SATURATION BELOW 90%. THESE APNEIC AND HYOXIC EPISODES WERE NOT ASSOCIATED WITH HEMODYNAMIC CHANGES.
THE OBSTRUCTIVE APNEA AND OXYGEN DESATURATION WAS AMELIOIATED BY CONTINUOUS POSITIVE AIRWAY PRESSURE.
IN CONCLUSION, GERIATRIC PATIENS UNDER EITHER SPINAL OR EPIDURAL ANESTHESIA UP TO T10 LEVEL WERE VERY SENSIYIVE TO RESPIRATORY DEPRESSANT EFFECTS OF LOW DOSE MIDAZOLAM OR PORPOFOL INFUSION. HEMODYNAMIC CHANGES WERE NOT A GOOD INDICATOR OF HYPOXEMIA UNDER REGIONAL ANESTHESIA. POSITIVE AIRWAY PRESSURE WAS EFFECTVE TO AIRWAY OBSTRUCTION AND OXYGEN SATURATIN WITH THESE SEDATIVE AGENTS. Less
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