Canadian Journal of Anesthesia, Vol 45, 564-567, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Patient outcomes with positive pressure versus spontaneous ventilation in non-paralysed adults with the laryngeal mask

C Keller, HJ Sparr, TJ Luger and J Brimacombe
Department of Anaesthesia and Intensive Care Medicine, Leopold-Franzens University, Innsbruck, Austria.

PURPOSE: To compare patient outcomes for positive pressure ventilation (PPV) and spontaneous ventilation (SV) in non-paralysed patients with the LMA using either isoflurane or sevoflurane anaesthesia. METHODS: One hundred and sixty four adult patients were studied. Anaesthesia was with fentanyl/propofol and N2O 66% in O2 with 0.75 MAC isoflurane or sevoflurane and either PPV or SV. Positive pressure ventilation was with tidal volumes of 6-8 ml.kg-1. Peak airway pressures were < 15 cm H2O. Patients were evaluated for airway problems, cardiorespiratory effects, and anaesthesia emergence times. RESULTS: There were no failed episodes of PPV or SV. Gastric insufflation was not detected by epigastric auscultation. Airway problems and cardiovascular effects were similar among groups. During maintenance: SpO2 was greater in the PPV group than in the SV group (98.4 vs 97%, P < 0.001); also, (PETCO2) (34 vs 43 mmHg) and the respiratory rate (RR) (15 vs 19 min-1) were higher and the minute ventilation (MV) (5.7 vs 7.2 L) were lower in the SV groups (P < 0.0001). Shorter times to LMA removal and orientation were observed in the sevoflurane groups (P < 0.0001). CONCLUSIONS: Patient outcome is similar for SV and PPV in non-paralysed adult patients with the LMA. Isoflurane and sevoflurane at 0.75 MAC provide suitable conditions for maintenance and emergence, but emergence is more rapid with sevoflurane.

This article has been cited by other articles:

				J. L. Bourgain, V. Billard, and A. M. Cros Pressure support ventilation during fibreoptic intubation under propofol anaesthesia Br. J. Anaesth., January 1, 2007; 98(1): 136 - 140. [Abstract] [Full Text] [PDF]

				T. W. Felbinger, S. R. Mallampati, and H. K. Eltzschig Airway management for postoperative respiratory failure: use of the laryngeal mask airway Can J Anesth, April 1, 2005; 52(4): 445 - 446. [Full Text] [PDF]

				S. M Siddik-Sayyid, M. T. Aouad, S. K. Taha, D. G. Daaboul, P. G. Deeb, F. M. Massouh, M.-R. A. Muallem, and A. S. Baraka A Comparison of Sevoflurane-Propofol Versus Sevoflurane or Propofol for Laryngeal Mask Airway Insertion in Adults Anesth. Analg., April 1, 2005; 100(4): 1204 - 1209. [Abstract] [Full Text] [PDF]

				J. K.L. Hui, L. A.H. Critchley, M. K. Karmakar, and P. K.K. Lam Co-administration of alfentanil-propofol improves laryngeal mask airway insertion compared to fentanyl-propofol: [La co-administration d'alfentanil et de propofol, comparee a celle de fentanyl et de propofol, ameliore l'insertion du masque larynge] Can J Anesth, May 1, 2002; 49(5): 508 - 512. [Abstract] [Full Text] [PDF]

				G. Sidaras and J. M. Hunter Editorial III: Is it safe to artificially ventilate a paralysed patient through the laryngeal mask? The jury is still out Br. J. Anaesth., June 1, 2001; 86(6): 749 - 753. [Full Text] [PDF]

				H. S. Joo and W. J. Perks Sevoflurane Versus Propofol for Anesthetic Induction: A Meta-Analysis Anesth. Analg., July 1, 2000; 91(1): 213 - 219. [Abstract] [Full Text] [PDF]