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The effects of different analgesic regimens on transcutaneous CO 2 after major surgery
Author(s) -
McCormack J. G.,
Kelly K. P.,
Wedgwood J.,
Lyon R.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05487.x
Subject(s) - medicine , anesthesia , analgesic , bolus (digestion) , patient controlled analgesia , morphine , opioid , surgery , receptor
Summary Ventilatory impairment may be detected by a rise in transcutaneous carbon dioxide levels (PtcCO 2 ). This observational study assessed the clinical utility of PtcCO 2 monitoring in the postoperative period, and quantified the effect of different peri‐operative analgesic regimens on postoperative respiratory function. Following pre‐operative baseline PtcCO 2 recording, continuous PtcCO 2 monitoring was performed in 30 patients after major colorectal surgery for up to 24 h. Mean postoperative values of PtcCO 2 were 1.3 kPa (95% CI 1.0–1.5) higher than pre‐operative values (p < 0.001). Patients receiving intravenous opioid patient controlled analgesia had a significantly higher elevation in postoperative PtcCO 2 compared to patients receiving epidural infusion analgesia, 1.8 kPa (CI 1.5–2.1) vs 0.7 kPa (CI 0.5–0.9) respectively (p < 0.001). The mean rise in PtcCO 2 following a single intravenous bolus of morphine delivered via PCA was 0.05 kPa (SEm 0.01), peaking at 12 min post‐dose. The transcutaneous capnometer successfully recorded data for 98% of the total time it was applied to patients.