J Korean Acad Pediatr Dent.  2018 Nov;45(4):508-513. 10.5933/JKAPD.2018.45.4.508.

Blood Gas Analysis of Respiratory Depression during Sevoflurane Inhalation Induction for General Anesthesia in the Disabled Patients

• Yoon T
• Kim S

• KMID: 2431343
• DOI: http://doi.org/10.5933/JKAPD.2018.45.4.508

Abstract

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes PaCO2 to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as 7.36 ± 0.06. The average amount of PvCOâ‚‚ of the entire patients was measured as 48.8 ± 8.50 mmHg. The average amount of HCO₃₋ of the entire patients was measured as 27.2 ± 3.0 mmol/L. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

Keyword

Patient with disabilities; Sevoflurane inhalation sedation; General anesthesia; Respiratory depression

MeSH Terms

Anesthesia, General*
Anesthesia, Inhalation
Anoxia
Blood Gas Analysis*
Hemodynamics
Humans
Hydrogen-Ion Concentration
Hypercapnia
Inhalation*
Masks
Muscle Relaxation
Nitrous Oxide
Oxygen
Respiration
Respiratory Insufficiency*
Tidal Volume
Unconsciousness
Veins
Ventilation
Nitrous Oxide
Oxygen