Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T02:03:25.660Z Has data issue: false hasContentIssue false

Pressure support ventilation during inhalational induction with sevoflurane and remifentanil in adults

Published online by Cambridge University Press:  13 October 2005

F. Banchereau
Affiliation:
Université Victor Segalen-Bordeaux II, Hôpital Pellegrin Enfants, DAR IV, Bordeaux, France
Y. Herve
Affiliation:
Université Victor Segalen-Bordeaux II, Bordeaux, France
A. Quinart
Affiliation:
Hôpital d'Instruction des Armées Robert Picqué, Département d'Anesthésie Réanimation, Hôpital Pellegrin, DAR I, Bordeaux, France
A.-M. Cros
Affiliation:
Université Victor Segalen-Bordeaux II, Hôpital Pellegrin Enfants, DAR IV, Bordeaux, France
Get access

Extract

Summary

Background and objective: The purpose of this prospective randomized study was to assess the value of pressure support ventilation during inhalational induction with sevoflurane in adult patients. Methods: Thirty-five adult patients, ASA I–II and scheduled for ear nose throat surgery were studied. Vital capacity induction with 8% sevoflurane in 8 L min−1 oxygen was performed. Pressure support ventilation was used in Group 1 with pressure set at 15 cmH2O. In Group 2, patients breathed spontaneously. After 2 min, sevoflurane was set to 3% and remifentanil 1 μg kg−1 was injected over 2 min followed by an infusion of 0.1μg kg−1 min−1. Two minutes after the end of the bolus, intubation was performed. Bispectral index, oxygen saturation, respiratory rate, end-tidal carbon dioxide, expired tidal volume and expired sevoflurane concentration were recorded every minute. Results: Eighteen patients were included in Group 1 and 17 in Group 2. Saturation, respiratory rate and end-tidal carbon dioxide were similar in the two groups. Expired tidal volume was significantly higher and bispectral index values significantly lower in Group 1. Intubating conditions were better in Group 1. Conclusions: Pressure support ventilation provides both better ventilation and deeper level of anaesthesia during inhalation induction with sevoflurane.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Yamaguchi S, Egawa H, Mishio M, Okuda Y, Kitajima T. Bispectral index monitoring during vital capacity rapid inhalation induction technique with sevoflurane. J Clin Anesth 2003; 15: 2428.Google Scholar
Doi M, Ikeda K. Respiratory effects of sevoflurane. Anesth Analg 1987; 66: 241244.Google Scholar
Ma D, Chakrabarti MK, Whitwam JG. The combined effects of sevoflurane and remifentanil on central respiratory activity and nociceptive cardiovascular responses in anesthetized rabbits. Anesth Analg 1999; 89: 453461.Google Scholar
Eger EI. New inhaled anesthetics. Anesthesiology 1994; 80: 906922.Google Scholar
Von Goedecke A, Voelckel WG, Wenzel V et al. Mechanical versus manual ventilation via a face mask during the induction of anesthesia: a prospective, randomised, crossover study. Anesth Analg 2004; 98: 260263.Google Scholar
Christie JM, Smith RA. Pressure support ventilation decreases inspiratory work of breathing during general anesthesia and spontaneous ventilation. Anesth Analg 1992; 75: 167171.Google Scholar
Langeron O, Masso E, Huraux C et al. Prediction of difficult mask ventilation. Anesthesiology 2000; 92: 12291236.Google Scholar
Viby-Mogensen J, Engbaek J, Eriksson LI et al. Good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents. Acta Anaesthesiol Scand 1996; 40: 5974.Google Scholar
Koscielniak-Nielsen ZJ, Horn A, Sztuk F, Eriksen K, Theil Skovgaard L, Viby-Mogensen J. Timing of tracheal intubation: monitoring the orbicularis oculi, the abductor pollicis or use a stopwatch? Eur J Anaesthesiol 1996; 13: 130135.Google Scholar
Brown K, Aun C, Stocks J, Jackson E, Mackersie A, Hatch D. A comparison of the respiratory effects of sevoflurane and halothane in infants and young children. Anesthesiology 1998; 89: 8692.Google Scholar
Rothen HU, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Re-expansion of atelectasis during general anesthesia: a computed tomography study. Br J Anaesth 1993; 71: 788795.Google Scholar
Weiler N, Heinrichs W. Assessment of pulmonary mechanics and gastric inflation pressure during mask ventilation. Prehosp Disas Med 1995; 10: 101105.Google Scholar
Nathan N, Bazin JE, Cros AM. Induction par inhalation. Ann Fr Anesth Réanim 2004; 23: 884889.Google Scholar
Godet G, Watremez C, El Kettani C, Soriano C, Coriat P. A comparison of sevoflurane, target controlled infusion of propofol and propofol/isoflurane anesthesia in patients undergoing carotid surgery: a quality of anesthesia and recovery profile. Anesth Analg 2001; 93: 560565.Google Scholar
Yamaguchi S, Ikeda T, Wake K, Okuda Y, Kitajima T. A sevoflurane induction with gradual reduction of concentration is well tolerated in elderly patients. Can J Anesth 2003; 50: 2631.Google Scholar