Korean J Anesthesiol.  2005 Mar;48(3):241-246. 10.4097/kjae.2005.48.3.241.

Comparison of Clinical Characteristics in Controlled Ventilation and Spontaneous Breathing during Vital Capacity Inhalation Induction with Sevoflurane

• Kil HK
• Lee YK
• Koo BN
• Park JH
• Kim WO
• Chun DH

• KMID: 2091970
• DOI: http://doi.org/10.4097/kjae.2005.48.3.241

Abstract

BACKGROUND: Although controlled ventilation can shorten the induction time during vital capacity inhalation induction (VCII) with sevoflurane, it may associated with decrease in blood pressure and hyperventilation-related hyperdynamic responses such as hypertension and tachycardia. This study was designed to compare the clinical effects between controlled ventilation (CV) within acceptable ranges of PETCO2 and spontaneous breathing (SB) during VCII.
METHODS
100 patients were randomly allocated to the one of two groups. After the loss of consciousness during VCII with sevoflurane, controlled ventilation was applied in CV group within acceptable ranges of PETCO2 and spontaneous breathing was maintained in SB group. Alfentanil 4 mcg/kg was given i.v. 2 minutes prior to intubation. PETCO2, mean arterial pressure (MAP), heart rate (HR), SPO2, and BIS were measured at 1, 2 and 3 minute after the loss of consciousness (LOC). Clinical side effects were evaluated.
RESULTS
MAP and HR were significantly decreased and increased in CV group compare to the baseline values at 1 minute after LOC. There were statistical differences of MAP and HR between two groups at 1 and 2 minutes after LOC. 46 of 50 (92%) showed delayed expiration with holding their breath > 20 s in SB group. No differences of other clinical side effects except hypotension between two groups.
CONCLUSIONS
We conclude that spontaneous breathing provides a stable hemodynamic status and relatively acceptable ventilation profile compare to controlled ventilation during VCII.

Keyword

controlled ventilation; sevoflurane; spontaneous breathing; vital capacity inhalation induction

MeSH Terms

Alfentanil
Arterial Pressure
Blood Pressure
Heart Rate
Hemodynamics
Humans
Hypertension
Hypotension
Inhalation*
Intubation
Respiration*
Tachycardia
Unconsciousness
Ventilation*
Vital Capacity*
Alfentanil