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Negative pressure ventilation vs. spontaneous assisted ventilation during rigid bronchoscopy. A controlled randomised trial
- Source :
- Europe PubMed Central
- Publication Year :
- 1998
-
Abstract
- BACKGROUND Ventilation during interventional rigid bronchoscopy (IRB) under general anaesthesia (jet ventilation, positive pressure ventilation and spontaneous assisted ventilation) may offer some difficulties. This study compares the effectiveness during IRB of intermittent negative pressure ventilation (INPV) and spontaneous assisted ventilation (SAV). METHODS Thirty-eight patients submitted to IRB were randomised into two groups: SAV or INPV. All patients received a total intravenous anaesthesia; INPV patients were paralysed. Pre- and intra-operative arterial blood gases and O2 flow through a rigid bronchoscope were assessed. The endoscopist applying a subjective score evaluated the operating conditions. RESULTS Patients of the INPV group, as compared to the SAV group, required a lower dosage of fentanyl (2.6 +/- 1.8 micrograms.kg-1.h-1 vs. 6.6 +/- 4.8 micrograms.kg-1.h-1), a lower O2 supply (3.3 +/- 2.8 l/min vs. 11.6 +/- 3.4 l/min), a shorter recovery time (5.4 +/- 2.9 min vs. 9.8 +/- 7.1 min) and no manually assisted ventilation (0 +/- 0 vs. 1 +/- 1.1 n degree/procedure). Intraoperative PaCO2 was higher in the SAV (8.1 +/- 1.3 kPa) than in the INPV group (5.0 +/- 1.6 kPa) and intraoperative pH differed in the two groups (7.26 +/- 0.05, SAV vs. 7.47 +/- 0.08, INPV). Operating conditions, as assessed by a subjective score, were considered better with INPV than with SAV (4.9 vs. 4.3). CONCLUSIONS As compared to SAV, INPV in paralysed patients during IRB reduces administration of opioids, shortens recovery time, prevents respiratory acidosis, excludes the need for manually assisted ventilation, reduces O2 need and affords optimal surgical conditions. INPV appears a safe, non-invasive and effective ventilatory management during IRB.
- Subjects :
- Artificial ventilation
Laser surgery
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Ventilators, Negative-Pressure
Fentanyl
Bronchoscopy
medicine
Humans
General anaesthesia
Aged
Aged, 80 and over
medicine.diagnostic_test
business.industry
General Medicine
Carbon Dioxide
Middle Aged
medicine.disease
Respiration, Artificial
Surgery
Oxygen
Respiratory acidosis
Anesthesiology and Pain Medicine
Anesthesia
Breathing
Arterial blood
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 00015172
- Volume :
- 42
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Acta anaesthesiologica Scandinavica
- Accession number :
- edsair.doi.dedup.....92ef8e4c9ede926475154a0e5071e147