Accelerated Recovery from Sevoflurane Anesthesia with Isocapnic Hyperpnoea

Abstract

IH accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.

Does hypocapnia before and during carbon dioxide insufflation attenuate the hemodynamic changes during laparoscopic cholecystectomy?

“…There is concern about the delayed awakening from anesthesia with the use of hypocapnia at the end of surgery because the accompanying hypocapnia reduces cerebral blood flow and may delay the washout of anesthetic from the brain compartment as well as the return of spontaneous ventilation [23]. We found no significant differences in the recovery time with the use of either hypocapnia or normocapnia because we altered the RR to maintain near normocapnia at the end of surgery after CO 2 desufflation.…”

Fast wake-up time in obese patients: Which anesthetic is best?

“…The relative longer recovery time from sevoflurane and isoflurane compared with desflurane can be overcome by, for example, augmenting minute ventilation on emergence. [9][10][11] It has been shown that as little as a two to threefold increase in minute ventilation, while avoiding hypocapnia (i.e., isocapnic hyperpnea), increases the rate of elimination of isoflurane compared with that of sevoflurane and desflurane in patients conventionally ventilated.…”

“…Compared with these factors and the minute ventilation at emergence, the independent effect of anesthetic blood solubility on arousal is quite small. [9][10][11] By appropriately adapting other aspects of the conduct of the anesthesia, the anesthesiologist can tailor the anesthetic to the needs of the obese patient with any of the three common volatile agents so the patient may still be able to wake up equally rapidly in the operating room. …”

“…[9][10][11] Dans ce numéro du Journal, Liu et coll. rapportent une méta-analyse s'intéressant aux pronostics de récupération de patients obèses ayant subi une anesthésie générale.…”

“…Par rapport à ces facteurs et la ventilation minute au réveil, l'effet indépendant de la solubilité dans le sang de l'agent anesthésique sur le réveil est relativement faible. [9][10][11] En adaptant de façon appropriée d'autres aspects de l'anesthésie, l'anesthésiologiste peut personnaliser l'anesthésie selon les besoins du patient obèse avec n'importe lequel des trois agents volatils facilement accessibles de façon à ce que le patient puisse se réveiller tout aussi rapidement en salle d'opération. …”