Hypercapnic Hyperventilation Shortens Emergence Time from Isoflurane Anesthesia

Sakata, Derek; Gopalakrishnan, Nishant; Orr, Joseph A.; White, Julia L.; Westenskow, Dwayne R.

doi:10.1213/01.ane.0000255074.96657.39

Cited by 32 publications

(43 citation statements)

References 14 publications

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“…[3910] and Brosnan et al ., in a study on horses, concluded that hypercapnic hyperpnea decreases time to standing without influencing anesthetic recovery quality. [11]…”

Section: Introductionmentioning

confidence: 99%

Hypercapnic hyperventilation shortens emergence time from Propofol and Isoflurane anesthesia

et al. 2013

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Objective:The aim of this study is to compare the effects of hypercapnic hyperventilation and normocapnic normoventilation on emergence time from propofol and isoflurane anesthesia.Methods:In this clinical trial, the differences in emergence time were evaluated in 80 patients undergoing elective abdominal surgery in Alzahra University hospital, Isfahan, Iran, in 2011-2012. Patients were randomly divided into four groups (groups 1-4) receiving isoflurane hypercapnic hyperventilation, isoflurane normocapnic normoventilation, propofol hypercapnic hyperventilation, and propofol normocapnic normoventilation, respectively. Hypercapnia was maintained by adding CO2 to the patient's inspired gas during hyperventilation. The emergence time and the duration of stay in recovery room in the four groups were measured and compared by one-way analysis of variance (ANOVA) and least significant difference tests.Findings:The average emergence time in groups 1, 2, 3, and 4 were (11.3 ± 3.2), (15.2 ± 3.8), (9 ± 4.2) and (11.8 ± 5.3) min, respectively. These differences were significant (P = 0.001). In patients receiving propofol hypercapnic hyperventilation, the emergence time was faster than in other groups. There was also a significant difference in duration of stay in recovery room between the groups (P = 0.004). Patients who received isoflurane hypercapnic hyperventilation had a shortest length of stay in the recovery room.Conclusion:The emergence time after intravenous anesthesia with propofol can be shortened significantly by using hyperventilation and hypercapnia, without any side effects.

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“…[3910] and Brosnan et al ., in a study on horses, concluded that hypercapnic hyperpnea decreases time to standing without influencing anesthetic recovery quality. [11]…”

Section: Introductionmentioning

confidence: 99%

Hypercapnic hyperventilation shortens emergence time from Propofol and Isoflurane anesthesia

et al. 2013

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“…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.…”

mentioning

confidence: 99%

“…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. …”

mentioning

confidence: 99%

“…[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.…”

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“…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. …”

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See 2 more Smart Citations

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

Katznelson

Fisher

2015

Can J Anesth/J Can Anesth

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Application and Efficiency of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange in Laryngeal Microsurgery

et al. 2021

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Objectives/Hypothesis This study aimed to analyze the feasibility of transnasal humidified rapid‐insufflation ventilatory exchange (THRIVE) during laryngeal microsurgery (LMS) and investigated its efficiency and application according to the location of the lesion. Study Design Retrospective chart review. Methods Patients over 20 years of age who underwent LMS without underlying cardiac, pulmonary, or cerebrovascular disease were retrospectively reviewed. Overall, 54 patients with endotracheal intubation (ETI) and 44 patients with THRIVE were included. The operation and anesthesia time, induction and emergence time, oxygen saturation (SpO2), and transcutaneous carbon dioxide (TcCO2) levels were analyzed and compared between the two ventilation methods according to disease subsite. Results Compared with ETI, patients with THRIVE presented reduced operation time (16.3 ± 9.69 min vs. 21.9 ± 12.0 min), anesthesia time (33.6 ± 11.4 min vs. 45.4 ± 13.9 min), emergence time (6.73 ± 2.49 min vs. 8.52 ± 3.17 min), without significant decreases in SpO2 but with increased TcCO2 (10.9 ± 6.12% vs. 7.33 ± 3.86%). Comparing THRIVE to ETI for lesions at the glottis yielded similar findings, which were particularly more significant. However, lesions above the glottis presented no significant difference for any parameters between THRIVE and ETI groups. Lesions involving multiple subsites and prolonged operation time were risk factors for the intraoperative conversion of ventilation method. Conclusion THRIVE is reliable for maintaining oxygenation during LMS and is efficient in reducing the operation and emergence times, leading to shorter anesthesia time, especially for lesions at the glottis. However, caution is required administering THRIVE, when lesion involves multiple subsites, and when operation time is prolonged. Level of Evidence 3 Laryngoscope, 132:1061–1068, 2022

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Hypercapnic Hyperventilation Shortens Emergence Time from Isoflurane Anesthesia

Cited by 32 publications

References 14 publications

Hypercapnic hyperventilation shortens emergence time from Propofol and Isoflurane anesthesia

Hypercapnic hyperventilation shortens emergence time from Propofol and Isoflurane anesthesia

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

Application and Efficiency of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange in Laryngeal Microsurgery

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