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Pressure support ventilation with the ProSeal® laryngeal mask airway. A comparison of sevoflurane, isoflurane and propofol

Published online by Cambridge University Press:  28 July 2005

C. Keller ,
J. Brimacombe ,
C. Hoermann ,
A. Loeckinger  and
A. Kleinsasser
C. Keller
Affiliation:
Leopold-Franzens University, Department of Anesthesia and Intensive Care Medicine, Innsbruck, Austria
J. Brimacombe
Affiliation:
University of Queensland and James Cook University, Department of Anesthesia and Intensive Care, Cairns Base Hospital, Cairns, Australia
C. Hoermann
Affiliation:
Leopold-Franzens University, Department of Anesthesia and Intensive Care Medicine, Innsbruck, Austria
A. Loeckinger
Affiliation:
Leopold-Franzens University, Department of Anesthesia and Intensive Care Medicine, Innsbruck, Austria
A. Kleinsasser
Affiliation:
Leopold-Franzens University, Department of Anesthesia and Intensive Care Medicine, Innsbruck, Austria
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Extract

Summary

Background and objective: There are no data about the influence of anaesthetics on cardiovascular variables during pressure support ventilation of the lungs through the laryngeal mask airway. We compared propofol, sevoflurane and isoflurane for maintenance of anaesthesia with the ProSeal® laryngeal mask airway during pressure support ventilation. Methods: Sixty healthy adults undergoing peripheral musculo-skeletal surgery were randomized for maintenance with sevoflurane end-tidal 2%, isoflurane end-tidal 1.1% or propofol 6 mg kg−1 h−1 in oxygen 33% and air. Pressure support ventilation comprised positive end-expiratory pressure set at 5 cmH2O, and pressure support set 5 cmH2O above positive end-expiratory pressure. Pressure support was initiated when inspiration produced a 2 cmH2O reduction in airway pressure. A blinded observer recorded cardiorespiratory variables (heart rate, mean blood pressure, oxygen saturation, airway occlusion pressure, respiratory rate, expired tidal volume, expired minute volume and end-tidal CO2), adverse events and emergence times. Results: Respiratory rate and minute volume were 10–21% lower, and end-tidal CO2 6–11% higher with the propofol group compared with the sevoflurane or isoflurane groups, but otherwise cardiorespiratory variables were similar among groups. No adverse events occurred in any group. Emergence times were longer with the propofol group compared with the sevoflurane or isoflurane groups (10 vs. 7 vs. 7 min). Conclusion: Lung ventilation is less effective and emergence times are longer with propofol than sevoflurane or isoflurane for maintenance of anaesthesia during pressure support ventilation with the ProSeal® laryngeal mask airway. However, these differences are small and of doubtful clinical importance.

Keywords

INTUBATION, INTRATRACHEAL, laryngeal masksPULMONARY VENTILATIONRESPIRATION, artificialpressure support ventilationVENTILATORS, mechanical
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 8 , August 2005 , pp. 630 - 633
Copyright
© 2005 European Society of Anaesthesiology

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