J.Jpn. Surg. Soc.. 55(10): 1120-1141, 1955
Original article
BLOOD-GAS ANALYSIS AND ANOXIA IN ANESTHESIA AND OPERATION
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Surgical Department, Tokyo Univertisy Branch Hospital Koichi KOYANO |
(1) Generally total blood-gas (O2+CO2) was greater in better risk patients than in poor risk.
(2) Arterial blood oxygen saturation was diminished by opium and scopolamine. This was considered as tidal anoxia caused by respiratory depression.
Usually oxygen inhalation restored this type of anoxia, but there were some who showed low arterial blood oxygen even with oxygen inhalation and normal respiratory volume. This was considered as alveolar anoxia.
Overdosis of opium and scopolamine, shock in spinal anesthesia or failure in ether anesthesia induced stagnant anoxia revealing oxygen reduction both in arterial and venous blood.
Opium-scopolamine or ether diminished arterio-venous difference of oxygen and carbon dioxide, and reduced alkali reserve. (histotoxic anoxia). Two remarkable cases of these histotoxic anoxia were shown.
(3) The following factors increased anoxia with reduction of effective ventilation; laryngospasm, kinking of tracheal tube, stenosis or obstruction of natural airway, collaps of the lung, elevation of the scapula, injury to pleura, intrathoracic reflexes, paradoxical respiration, excessive fixation of thorax by adhesive tape and intrathoracic fluid accumlation.
(4) There is no mathematical relation between the blood oxygen saturation rate and manifestation of anoxia
Symptoms of anoxia not always revealed itself in the presence of anoxemia. One cannot put anoxemia and anoxia in the same category. Existence of anoxia is the matter of balance between oxygen demand of an organism and its supply.
(5) Anoxia must be found early and proper measure is to be taken immediately.
(author's abstract)
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