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Abdominal relaxation during emergence from general anesthesia with propofol and remifentanil.

Abstract：

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.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Atkins JH,Mandel JE

doi

10.1016/j.jclinane.2012.06.025

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

106-9

issue

2

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(13)00011-1

journal_volume

25

pub_type

杂志文章

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