Abstract
Carbon dioxide elimination (VCO2) was measured in 186 anaesthetized, spontaneously breathing infants and children with body weights ranging from 2.8 to 26.5 kg. They all underwent minor paediatric surgical procedures. The influence on VCO2 of age, operation, premedication, caudal anaesthesia, and different volatile anaesthetic agents was investigated. The volume of exhaled gas, during three- to five-minute collection periods, was measured and the fraction of exhaled CO2 was determined by a CO2 meter. Under basal anaesthetic conditions, the average output before operation followed the equation: VCO2 (ml·min-1) = -1.25X + 13.0X2, in which X = lne (body weight, kg). Expressed on a weight basis, the youngest infants (weighing less than 5 kg) had the lowest VCO2. Higher values were measured up to a body weight of 10 kg above which a negative correlation occurred between VCO2 (ml·min-1·kg-1) and body weight. The use of premedication resulted in a more variable VCO2 during operations than when opioid premedication was not used. The combination of a general anaesthetic and caudal anaesthesia stabilized VCO2. Also, children anaesthetized with halothane had a higher VCO2 than those who were anaesthetized with enflurane or isoflurane (P < 0.05). The variable VCO2 emphasizes the need for increased monitoring of VCO2 during routine anaesthesia and operation in infants and children.
Résumé
Ľélimination du CO2 (VCO2) a été mesurée chez 186 nouveau-nés et enfants dont le poids variait de 2.8 à 26.5 kg respirant spontanément. Tous ont subi une opération chirurgicale mineure. Ľinfluence sur la VCO2 de ľâge, ľopération, la prémédication, ľanesthésie caudale et les différents agents anesthésiques volatils ont été investigués. Le volume du gaz expiré, pour des périodes de collection de trois à cinq minutes, était mesuré et la fraction du CO2 expiré était déterminée par un capnomètre. Sous des conditions anesthésiques normales, ľélimination moyenne durant ľopération correspondait à ľéquation: VCO2 (ml·min-1) =- 1.25X + 13.0X2 ou X = lne (poids corporel, kg). Exprimés selon le poids, les nouveau-nés (pesant moins que 5 kg) avaient les valeurs de VCO2 les plus basses. Les valeurs plus élevées étaient mesurées jusqu’à un poids de 10 kg au-delà duquel une corrélation négative est survenue entre la VCO2 (ml·min-1 kg-1) et le poids corporel. La prémédication a amené des variations dans les valeurs de la VCO2 durant les opérations alors qu’on n’a retrouvé aucune variation en ľabsence de prémédication. Ľassociation de ľanesthésie générale et de ľanesthésie caudale a stabilisé la VCO2. Aussi les enfants anesthésiés avec ľhalothane avaient des valeurs de VCO2 plus élevées que ceux anesthésiés avec ľenflurane ou ľisoflurane (P < 0.05). La variation de la VCO2 suggère la nécessité de la surveiller durant une anesthésie de routine chez les nouveau-nés et les enfants.
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Lindahl, S.G.E., Offord, K.P., Johannesson, G.P. et al. Carbon dioxide elimination in anaesthetized children. Can J Anaesth 36, 113–119 (1989). https://doi.org/10.1007/BF03011430
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DOI: https://doi.org/10.1007/BF03011430