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Anesth Analg 2008; 106:486-491
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181602dd4
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ANESTHETIC PHARMACOLOGY

Accelerated Recovery from Sevoflurane Anesthesia with Isocapnic Hyperpnoea

Rita Katznelson, MD*, Leonid Minkovich, MD, PhD*, Zeev Friedman, MD{dagger}, Ludvik Fedorko, MD, PhD, FRCPC*, W. Scott Beattie, MD, PhD, FRCPC*, and Joseph A. Fisher, MD, FRCP(C)*

From the *Department of Anesthesia, Toronto General Hospital, and {dagger}Mount Sinai Hospital, University Health Network, University of Toronto, Toronto, Ontario.

Address correspondence and reprint requests to Rita Katznelson, MD, Department of Anesthesiology, Toronto General Hospital, Eaton North 3-453, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada. Address e-mail to rita.katznelson{at}uhn.on.ca.

BACKGROUND: Isocapnic hyperpnoea (IH) reduces recovery time from isoflurane anesthesia in animals and humans. We studied the effect of IH on the emergence profile of sevoflurane-anesthetized patients by comparing postoperative recovery variables in patients administered IH (IH group) to those recovered in the customary fashion (control group).

METHODS: We enrolled 30 ASA I–III patients undergoing elective gynecological surgery. Induction and maintenance of anesthesia were standardized with a protocol consisting of fentanyl, propofol, rocuronium, and sevoflurane in air/O2. Patients were randomly assigned to control (C) or IH groups at the end of the surgery. We recorded time intervals from discontinuing sevoflurane to recovery milestones.

RESULTS: Time to tracheal extubation was much shorter in the IH group compared with group C (6.2 ± 2.1 vs 12.3 ± 3.8 min, respectively, P < 0.01). The IH group also had shorter times to initiation of spontaneous ventilation (4.2 ± 1.7 vs 6.5 ± 3.8 min, P = 0.047), eye opening (5.5 ± 1.4 vs 13.3 ± 4.4 min, P < 0.01), bispectral index value >75 (3.9 ± 1.1 vs 8.8 ± 3.7 min, P < 0.01), leaving operating room (7.7 ± 2.0 vs 15.3 ± 3.4 min, P < 0.01), and eligibility for postanesthetic care unit discharge (67.2 ± 19.3 vs 90.6 ± 20.0 min, P < 0.01).

CONCLUSION: IH accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.