Hypercapnic Hyperpnoea during Emergence with the QED-100 Shortens the
D. Sakata1, D. Westenskow2, N. Syroid2, D. Tyler2, J. White2, C. Jacobson2;
INTRODUCTION: A more rapid return of responsiveness occurs after inhaled anesthesia when hypercapnia and hyperpnoea are used during emergence1-4. The benefits extend into the post anesthesia care unit5. This study measured the decrease in time to meet recovery criteria in the PACU when hypercapnic hyperpnoea was used during emergence in the operating room.
METHODS: Written informed consent was obtained from 22 adult ASA class I-III patients scheduled to undergo eye surgery. Anesthesia was provided with 6% desflurane and a remifentanil infusion. At the end of surgery patients were randomly assigned to one of the two treatment groups. In the experimental group a QED-100 (Anecare Inc., Salt Lake City, UT) was placed between the endotracheal tube and the anesthesia breathing circuit and the respiratory rate was doubled.
RESULTS: When the QED-100 was used to provide hypercapnic hyperpnoea during emergence (respiratory rate was doubled and the EtCO2 was elevated to 48 mmHg, rather than 35 mmHg) the time from the end of surgery to when patients opened their eyes to command was 4.1 + 1.4 min whereas the time for the control group was 6.5 + 2.3 min (P = 0.009). The time from the end of surgery until the patient became oriented and could correctly state their full name, date, month and year of birth and the current year was 10.9 + 5.1 min for the hypercapnic group and 18.2 + 9.7 for the control group (P = 0.039).