Abdominal relaxation during emergence from general anesthesia with propofol and remifentanil - 08/03/13
: Assistant Professor of Anesthesiology and Critical Care; Assistant Professor of Otorhinolaryngology: Head and Neck Surgery, Jeff E. Mandel, MD, MS : Assistant Professor of Anesthesiology and Critical CareAbstract |
Study Objective |
To characterize respiratory dynamics during emergence from propofol-remifentanil anesthesia using noninvasive respiratory inductance plethysmography (RIP).
Design |
Observational pilot study.
Setting |
Operating room in a university-affiliated teaching hospital.
Patients |
50 ASA physical status 1, 2, and 3 patients scheduled for microdirect laryngoscopy or bronchoscopy using total intravenous anesthesia (TIVA) with high-frequency jet ventilation.
Interventions |
Patients were fitted with plethysmography bands around the chest and abdomen prior to induction. Following completion of surgery in patients undergoing brief airway procedures using propofol-remifentanil general anesthesia, the anesthetic infusions were stopped and ventilation suspended until resumption of spontaneous ventilation or desaturation below 90%. During this period of apnea, abdominal and thoracic girth was assessed with noninvasive RIP.
Measurements |
Cross-sectional area of the thorax and abdomen during emergence were measured.
Main Results |
Useful data were obtained from 41 patients, with stable apnea lasting 404 ± 193.1 seconds; of these, 34 exhibited a slow and significant decrease in abdominal girth over a period of 267.8 ± 128.5 seconds. Resumption of spontaneous ventilation generally coincided with the end of this abdominal relaxation.
Conclusion |
Slow expiration is the initial step in the resumption of spontaneous ventilation during apnea induced with TIVA using propofol-remifentanil.
Le texte complet de cet article est disponible en PDF.Keywords : Anesthesia emergence, Opioid-induced apnea, Remifentanil, Respiratory inductance plethysmography, Respiratory physiology
Plan
| ☆ | The authors have no conflicts of interest to declare. |
| ☆☆ | Supported by departmental funding only. |
Vol 25 - N° 2
P. 106-109 - mars 2013 Retour au numéro
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