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Co2?

CRNA   (1,402 Views 7 Comments)
by meandragonbrett meandragonbrett (Member) Member

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I shadowed a CRNA yesterday for 12 hours. I had a great time and learned quite a bit. He was telling me something about normal CO2 being 35-45. I can't remember what he said when it goes above 45 towards the end of the anesthsia. Can you guys help? I've can't remember!

Brett

btw- do you guys know of any good anesthesia sites besides the one done by the airforce major?

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Increased CO2 is neccessary to stimulate the respiratory drive. Under inhaled anesthesia or narcotics the CO2 response curve is shifted to the right. So, if you want your patient to begin breathing while still under anesthesia or if they have narcotics on board, you must allow their CO2 to rise. Sometimes as high as 60-70 is needed to initiate. Towards the end of the case, many turn the vent off and only ventilate enough to keep the saturation up. Eventually patients will start to breath, this helps when it is time to actually wake up and also allows you to estimate level of analgesia. Ther's more but later.

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Is this the reason why some patients remember something for a brief moment after surgery, and then the next thing they know they are back in their room?

Nick

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No, the reason people remember things during surgery is that they aren't deep enough. If relaxed, it is difficult to fully assess their LOC although there are guidelines and assessmet clues. The CO2 level has nothing to do with it. CO2 can be high or low without relatiionship to recall. BTW most with recall don't experience pain. One very good reaseon not to paralyze everyone routinely is recall.

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Hmm, Learn something new everyday. I cam glad my past few experiences at the oral surgeon have gone well. This last one I started to wake up as they were finishing and I remember them finishing up the last stitch. Felt the pressure, but that was it.

Nick

PS: Was very comfortably relaxed too lol.

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