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Post-operative hypercapnia-induced hyperpnoea accelerates recovery from sevoflurane anaesthesia: a prospective randomised controlled trial.
Katznelson, R; Djaiani, G; Naughton, F; Wasowicz, M; Ragoonanan, T; Duffin, J; Fedorko, L; Murphy, J; Fisher, J A.
Afiliación
  • Katznelson R; Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada. rita.katznelson@uhn.ca
Acta Anaesthesiol Scand ; 57(5): 623-30, 2013 May.
Article en En | MEDLINE | ID: mdl-23452265
BACKGROUND: The time to recovery from vapour anaesthesia is shortened by an increase in ventilation while maintaining normocapnia. Hypercapnia during emergence from anaesthesia in spontaneously breathing patients also increases anaesthetic clearance from the brain by increasing cerebral blood flow. We hypothesised that hypercapnia-induced hyperpnoea accelerates emergence from sevoflurane anaesthesia compared to the standard anaesthesia protocol. METHODS: After Ethics Review Board approval, 44 ASA I-III patients undergoing elective gynaecological surgery were randomised after surgery to either hypercapnic hyperpnoea or control groups. In the hypercapnic hyperpnoea group, the end-tidal CO2 was adjusted to a range of 6.0-7.3 kPa to maintain a minute ventilation of 10-15 l/min. Recovery indices were compared using unpaired t-tests and ANOVA. RESULTS: Prior to extubation, minute ventilation and end-tidal CO2 in hypercapnic hyperpnoea and control groups were 10.3 ± 1.7 l/min vs. 5.4 ± 1.2 l/min (P < 0.001) and 6.6 ± 0.6 kPa and 5.2 ± 0.5 kPa (P < 0.001), respectively. Compared to control, the study group had shorter time to extubation [4.4 ± 1.3 (SD) vs. 9.8 ± 4.4 min, P < 0.01], BIS recovery to > 75 (2.4 ± 0.9 vs. 6.1 ± 3.1 min, P < 0.01), eye opening (3.9 ± 1.6 vs. 9.8 ± 6.2 min, P < 0.01), eligibility for leaving operating room (5.1 ± 1.2 vs. 11.1 ± 4.6 min, P < 0.01), and post-anaesthesia care unit (73.9 ± 14.2 vs. 89.4 ± 22.6) CONCLUSION: Hypercapnic hyperpnoea in spontaneously breathing patients halves the time of recovery from sevoflurane-induced anaesthesia in the operating room.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Periodo de Recuperación de la Anestesia / Anestésicos por Inhalación / Hipercapnia / Hiperventilación / Éteres Metílicos Tipo de estudio: Clinical_trials / Observational_studies Aspecto: Ethics Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Acta Anaesthesiol Scand Año: 2013 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Periodo de Recuperación de la Anestesia / Anestésicos por Inhalación / Hipercapnia / Hiperventilación / Éteres Metílicos Tipo de estudio: Clinical_trials / Observational_studies Aspecto: Ethics Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Acta Anaesthesiol Scand Año: 2013 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido