Transient Hyperdynamic Response Associated with Controlled Hypocapneic Hyperventilation During Sevoflurane-Nitrous Oxide Mask Induction in Adults
Autor: | Arvi Yli-Hankala, Kari Korttila, A. Vakkuri, Leena Lindgren |
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Rok vydání: | 1999 |
Předmět: |
Adult
Methyl Ethers Artificial ventilation Mean arterial pressure medicine.medical_treatment Nitrous Oxide Hemodynamics Blood Pressure Laryngeal Masks Sevoflurane Hypocapnia Heart Rate Hyperventilation medicine Humans Prospective Studies business.industry Carbon Dioxide Middle Aged medicine.disease Respiration Artificial Anesthesiology and Pain Medicine Blood pressure Anesthesia Anesthetics Inhalation Breathing Female medicine.symptom Anesthesia Inhalation business medicine.drug |
Zdroj: | Anesthesia & Analgesia. 88:1384-1388 |
ISSN: | 0003-2999 |
Popis: | UNLABELLED: We assessed hemodynamic variables during sevoflurane face mask anesthetic induction in female ASA physical status I or II patients. Anesthesia was induced with a single-breath inhalation method with 8% sevoflurane in 50% nitrous oxide in oxygen. Thirty patients were randomized either to breathe spontaneously (SB group, n = 15) or to receive controlled ventilation (CV group, n = 15) for 6 min after the loss of consciousness. Noninvasive blood pressure and heart rate (HR) were recorded at 1-min intervals. Mean +/- SD HR increased from 83+/-18 to 112+/-24 bpm at 4 min in the CV group (P < 0.001 between groups and within group compared with baseline). Mean arterial pressure increased from 97+/-9 to 106+/-26 mm Hg at 4 min in the CV group, which was significantly higher than that in the SB group (P < 0.01). In the SB group, mean arterial pressure decreased significantly, from 96+/-8 to 78+/-13 mmHg, at 6 min (P < 0.001), and HR remained unchanged. Therefore, hyperventilation should be avoided during the induction of sevoflurane anesthesia via a mask. IMPLICATIONS: In this randomized, prospective study, we found that controlled hypocapneic hyperventilation delivered manually during sevoflurane/ N2O/O2 mask induction was associated with a significant transient hyperdynamic response. This kind of hemodynamic arousal can be detrimental to many patients and can be avoided by conducting sevoflurane mask induction with unassisted spontaneous breathing. |
Databáze: | OpenAIRE |
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