Document Detail

Isocapnic hyperpnoea accelerates recovery from isoflurane anaesthesia.
MedLine Citation:
PMID:  14633745     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hyperventilation should speed up elimination of volatile anaesthetic agents from the body, but hyperventilation usually results in hypocapnia. We compared recovery from isoflurane anaesthesia in patients allowed to recover with assisted spontaneous ventilation (control) and those treated with isocapnic hyperpnoea. METHODS: Fourteen patients were studied after approximately 1 h of anaesthesia with isoflurane. Control patients were allowed to recover in the routine way. Isocapnic hyperpnoea patients received 2-3 times their intraoperative ventilation using a system to maintain end tidal PCO(2) at 45-50 mm Hg. We measured time to removal of the airway and rate of change of bispectral index (BIS) during recovery. RESULTS: With isocapnic hyperpnoea, the time to removal of the airway was markedly less (median and interquartile range values of 3.6 (2.7-3.7) vs 12.1 (6.8-17.2) min, P<0.001); mean (SD) BIS slopes during recovery were 11.8 (4.4) vs 4.3 (2.7) min(-1) (P<0.01) for isocapnic hyperpnoea and control groups, respectively. Isocapnic hyperpnoea was easily applied in the operating room. CONCLUSIONS: Isocapnic hyperpnoea at the end of surgery results in shorter and less variable time to removal of the airway after anaesthesia with isoflurane and nitrous oxide.
A Vesely; J A Fisher; N Sasano; D Preiss; R Somogyi; H El-Beheiry; A Prabhu; H Sasano
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  91     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-11-24     Completed Date:  2004-01-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  787-92     Citation Subset:  IM    
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Canada, M5G 2C4.
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MeSH Terms
Anesthesia Recovery Period*
Anesthetics, Combined / pharmacokinetics
Anesthetics, Inhalation / pharmacokinetics*
Carbon Dioxide / blood
Electroencephalography / drug effects
Isoflurane / pharmacokinetics*
Metabolic Clearance Rate / drug effects
Middle Aged
Nitrous Oxide / pharmacokinetics
Partial Pressure
Postoperative Care / methods
Respiration, Artificial / instrumentation,  methods*
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 10024-97-2/Nitrous Oxide; 124-38-9/Carbon Dioxide; 26675-46-7/Isoflurane

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