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Respiration during emergence from anaesthesia with desflurane/N 2 O vs. desflurane/air for gynaecological laparoscopy
Author(s) -
Einarsson S. G.,
Cerne A.,
Bengtsson A.,
Stenqvist O.,
Bengtson J. P.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05276.x
Subject(s) - desflurane , anesthesia , medicine , hypercapnia , general anaesthesia , nitrous oxide , ventilation (architecture) , respiratory system , respiratory minute volume , propofol , acidosis , mechanical engineering , engineering
Background: The complications related to anaesthesia usually occur in the early postoperative period. Hypercapnia and hypoxaemia may result from any persistent depression of the respiratory drive relative to the metabolic demand. The purpose of this study was to compare the respiratory effects of desflurane anaesthesia with or without nitrous oxide during the period of emergence. Methods: Twenty patients scheduled for a standardised surgical procedure, laparoscopic hysterectomy, were randomly allocated to anaesthesia with 1.3 MAC of desflurane/N 2 O (Group 1) or desflurane alone (Group 2), with 10 patients in each group. Times of resumption of spontaneous breathing and extubation were recorded and elimination rates of carbon dioxide, end‐tidal concentrations of desflurane and N 2 O, and blood gases were measured. Results: Spontaneous breathing was resumed in both groups when pH had decreased by about 0.07 and PaCO 2 increased by about 1.4 kPa compared with the values at the end of 1.3 MAC anaesthesia with controlled normoventilation. There were no significant differences between the groups with regards to extubation time, 6 vs. 13 min, or total MAC value at extubation, 0.20 vs. 0.19 in Group 1 and 2, respectively. Neither did the groups differ in minute ventilation, end‐tidal carbon dioxide, oxygen concentrations, or blood gases. CO 2 elimination decreased in both groups from about 220 ml 70 kg −1 min −1 at the end of anaesthesia to a lowest value of about 160 ml 70 kg −1 min −1 . Conclusion: The respiratory profiles during recovery from gynaecological laparoscopy with either desflurane/N 2 O or desflurane anaesthesia were similar with fast resumption of spontaneous breathing, short time to extubation, and no signs of CO 2 retention.