Pressure support ventilation during inhalational induction with sevoflurane and remifentanil in adults.
OBJECTIVE
The purpose of this prospective randomized study was to assess the value of pressure support ventilation during inhalational induction with sevoflurane in adult patients.


METHODS
Thirty-five adult patients, ASA I-II and scheduled for ear nose throat surgery were studied. Vital capacity induction with 8% sevoflurane in 8 L min-1 oxygen was performed. Pressure support ventilation was used in Group 1 with pressure set at 15 cmH2O. In Group 2, patients breathed spontaneously. After 2 min, sevoflurane was set to 3% and remifentanil 1 microg kg(-1) was injected over 2 min followed by an infusion of 0.1 microg kg(-1) min(-1). Two minutes after the end of the bolus, intubation was performed. Bispectral index, oxygen saturation, respiratory rate, end-tidal carbon dioxide, expired tidal volume and expired sevoflurane concentration were recorded every minute.


RESULTS
Eighteen patients were included in Group 1 and 17 in Group 2. Saturation, respiratory rate and end-tidal carbon dioxide were similar in the two groups. Expired tidal volume was significantly higher and bispectral index values significantly lower in Group 1. Intubating conditions were better in Group 1.


CONCLUSIONS
Pressure support ventilation provides both better ventilation and deeper level of anaesthesia during inhalation induction with sevoflurane.
Banchereau
F
F
Université Victor Segalen-Bordeaux II, Hôpital Pellegrin Enfants, DAR IV, Bordeaux, France. francois.banchereau@chu-bordeaux.fr
Herve
Y
Y
Quinart
A
A
Cros
A-M
AM
D000328:Adult; D000769:Anesthesia, Inhalation / Q000379:methods*; D019162:Anesthetics, Combined; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008738:Methyl Ethers; D013517:Otorhinolaryngologic Surgical Procedures; D010880:Piperidines; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D000077208:Remifentanil; D012131:Respiratory Insufficiency / Q000517:prevention & control*; D015656:Respiratory Mechanics; D000077149:Sevoflurane; D013990:Tidal Volume; D013997:Time Factors
D019162:Anesthetics, Combined; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil