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LETTER TO THE EDITOR

Ventilatory Support During Neuraxial Blockade Using Bilevel Positive Airway Pressure in a Patient with Severe Respiratory Compromise

Arrowe Park Hospital; Upton (Wirral), UK; pbapat{at}hotmail.com

To the Editor:

I have used a technique similar to that reported by Warren and Sharma (1) to assist respiration during neuraxial blockade and found it to be very useful (2). However, Warren and Sharma erroneously stated that Iwama (3) successfully used Bilevel positive airway pressure (BiPAP®) to provide ventilatory support in a patient with severe respiratory compromise. Iwama actually studied 213 patients of ASA status I/II and concluded that BiPAP 14/8 cm H₂O at a rate of 10 breaths/min can provide respiratory support in patients anesthetized with combined epidural-general anesthesia.

Footnotes

Dr. Sharma does not wish to respond.

REFERENCES

1. Warren J, Sharma SK. Ventilatory support using Bilevel positive airway pressure during neuraxial blockade in a patient with severe respiratory compromise. Anesth Analg 2006;102:910–11.[Abstract/Free Full Text]
2. Bapat PP, Anderson JA, Bapat S, Sule A. Use of continuous positive airway pressure (CPAP) to facilitate spontaneous respiration during spinal anaesthesia in a patient with severe chronic obstructive pulmonary disease (COPD). Anaesthesia. 2006;61:1001–3.[Web of Science][Medline]
3. Iwama H. Application of nasal bi-level positive airway pressureto respiratory support during combined epidural-propofol anesthesia. J Clin Anesth 2002;14:24–33.[Web of Science][Medline]

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