Cargando…

Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial

We tested the hypothesis that pressure-support ventilation (PSV) allows a reduction in emergence time and laryngeal mask airway (LMA) removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV). Because spontaneous breathing (SB) is often used with LMA under gene...

Descripción completa

Detalles Bibliográficos
Autores principales: Capdevila, Xavier, Jung, Boris, Bernard, Nathalie, Dadure, Christophe, Biboulet, Philippe, Jaber, Samir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275214/
https://www.ncbi.nlm.nih.gov/pubmed/25536515
http://dx.doi.org/10.1371/journal.pone.0115139
_version_ 1782350097922654208
author Capdevila, Xavier
Jung, Boris
Bernard, Nathalie
Dadure, Christophe
Biboulet, Philippe
Jaber, Samir
author_facet Capdevila, Xavier
Jung, Boris
Bernard, Nathalie
Dadure, Christophe
Biboulet, Philippe
Jaber, Samir
author_sort Capdevila, Xavier
collection PubMed
description We tested the hypothesis that pressure-support ventilation (PSV) allows a reduction in emergence time and laryngeal mask airway (LMA) removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV). Because spontaneous breathing (SB) is often used with LMA under general anesthesia, patients were allocated randomly to three groups (CMV, SB and PSV). Thirty-six consecutive ASA I–II patients scheduled for knee arthroscopic surgery under general anesthesia with a LMA and breathing throughout the ventilator circuit were included. Hemodynamic and ventilatory variables were recorded before and 10-min after general anesthesia-induction, at the surgical incision, at the end of anaesthetic drugs infusion and when the patient was totally awake (which defines emergence time). LMA removal time, drug consumption were recorded at the end of the surgical procedure. Leak fraction around the LMA was also evaluated. LMA removal time was significantly higher in the CMV-group (18±6 min) compared to both SB (8±4 min) and PSV (7±4 min, P<0.05) groups as well as for emergence time: CMV-group (32±12 min), SB (17±7 min) and PSV (13±6 min, P<0.05) groups. Total propofol consumption was significantly lower in the PSV-group (610±180 mg) than in both CMV (852±330 mg) and SB (734±246 mg, P<0.05) groups. Air leaks around the LMA was significantly higher in the CMV-group than in the SB and PSV groups (16% vs 3% and 7%, all P<0.05). In conclusion, in knee arthroscopic surgery, in comparison to CMV, PSV use during general anesthesia in unparalyzed patients decreases LMA removal time, propofol consumption and leaks around LMA while improving ventilatory variables without adverse effects. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN17382426
format Online
Article
Text
id pubmed-4275214
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-42752142014-12-31 Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial Capdevila, Xavier Jung, Boris Bernard, Nathalie Dadure, Christophe Biboulet, Philippe Jaber, Samir PLoS One Research Article We tested the hypothesis that pressure-support ventilation (PSV) allows a reduction in emergence time and laryngeal mask airway (LMA) removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV). Because spontaneous breathing (SB) is often used with LMA under general anesthesia, patients were allocated randomly to three groups (CMV, SB and PSV). Thirty-six consecutive ASA I–II patients scheduled for knee arthroscopic surgery under general anesthesia with a LMA and breathing throughout the ventilator circuit were included. Hemodynamic and ventilatory variables were recorded before and 10-min after general anesthesia-induction, at the surgical incision, at the end of anaesthetic drugs infusion and when the patient was totally awake (which defines emergence time). LMA removal time, drug consumption were recorded at the end of the surgical procedure. Leak fraction around the LMA was also evaluated. LMA removal time was significantly higher in the CMV-group (18±6 min) compared to both SB (8±4 min) and PSV (7±4 min, P<0.05) groups as well as for emergence time: CMV-group (32±12 min), SB (17±7 min) and PSV (13±6 min, P<0.05) groups. Total propofol consumption was significantly lower in the PSV-group (610±180 mg) than in both CMV (852±330 mg) and SB (734±246 mg, P<0.05) groups. Air leaks around the LMA was significantly higher in the CMV-group than in the SB and PSV groups (16% vs 3% and 7%, all P<0.05). In conclusion, in knee arthroscopic surgery, in comparison to CMV, PSV use during general anesthesia in unparalyzed patients decreases LMA removal time, propofol consumption and leaks around LMA while improving ventilatory variables without adverse effects. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN17382426 Public Library of Science 2014-12-23 /pmc/articles/PMC4275214/ /pubmed/25536515 http://dx.doi.org/10.1371/journal.pone.0115139 Text en © 2014 Capdevila et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Capdevila, Xavier
Jung, Boris
Bernard, Nathalie
Dadure, Christophe
Biboulet, Philippe
Jaber, Samir
Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title_full Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title_fullStr Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title_full_unstemmed Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title_short Effects of Pressure Support Ventilation Mode on Emergence Time and Intra-Operative Ventilatory Function: A Randomized Controlled Trial
title_sort effects of pressure support ventilation mode on emergence time and intra-operative ventilatory function: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275214/
https://www.ncbi.nlm.nih.gov/pubmed/25536515
http://dx.doi.org/10.1371/journal.pone.0115139
work_keys_str_mv AT capdevilaxavier effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial
AT jungboris effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial
AT bernardnathalie effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial
AT dadurechristophe effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial
AT bibouletphilippe effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial
AT jabersamir effectsofpressuresupportventilationmodeonemergencetimeandintraoperativeventilatoryfunctionarandomizedcontrolledtrial