[Clinical-and-pathophysiological prerequisites of impaired breathing and ensuring of safety in drug-induced depression of consciousness].
Seventy-three patients operated on under anesthesia based on regional blocks were examined. Thiopental-sodium (T; n = 29), myadozalam (M; n = 10) and propofol (P; n = 24) were used for sedation. The conditions of breathing and of gas exchange were evaluated by the findings of pneumotachography: V(peak insp), P(peak insp), P(100) Raw, breathing pattern, SpO2, PEtCO2 and EMG from mouth-diagram muscles. The obtained results were made use of to draw up a rating scale for impaired breathing, which is based on the respiratory volume and respiration rate of gas exchange as well as on different variations of respiratory support. Irrespective of a sedation type and of a degree of consciousness suppression, the impaired breathing was registered in 90-100% of cases: obstruction of the respiratory tracts was predominant in T (higher Raw); in M--depression of the respiratory center (lower P(100); in P--a pronouncedly lower of EMG, and, respectively, a weakened contraction of diaphragm (lower P(peak insp)). Depression of the respiratory center was found to occur irrespectively of a drug used in sedation, however, the mechanisms of obstruction were different: in T--impaired breathing; in M--impaired phase muscle activity. Sedation by P was not accompanied by any clinically valuable obstructive signs.
Zaĭtsev
A Iu
AIu
Svetlov
V A
VA
Kozlov
S P
SP
Karavaev
B I
BI
Svirshchevskiĭ
E B
EB
D016292:Procedural Sedation; D003243:Consciousness / Q000187:drug effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009126:Muscle Relaxation / Q000187:drug effects*; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012119:Respiration / Q000187:drug effects*; D013514:Surgical Procedures, Operative; D013990:Tidal Volume / Q000187:drug effects
D006993:Hypnotics and Sedatives