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Pressure support ventilation-pro decreases propofol consumption and improves postoperative oxygenation index compared with pressure-controlled ventilation in children undergoing ambulatory surgery: a randomized controlled trial.
Canadian Journal of Anesthesia ( IF 3.4 ) Pub Date : 2020-01-02 , DOI: 10.1007/s12630-019-01556-9
Swapnabharati Moharana 1 , Divya Jain 1 , Neerja Bhardwaj 1 , Komal Gandhi 1 , Sandhya Yaddanapudi 1 , Badal Parikh 1
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PURPOSE The PSVPro mode is increasingly being used for surgeries under laryngeal mask airway owing to improved ventilator-patient synchrony and decreased work of breathing. We hypothesized that PSVPro ventilation mode would reduce consumption of anesthetic agents compared with pressure control ventilation (PCV). METHODS Seventy children between three and eight years of age undergoing elective lower abdominal and urological surgery were randomized into PCV group (n = 35) or PSVPro group (n = 35). General anesthesia was induced with sevoflurane and a Proseal LMA™ was inserted. Anesthesia was maintained with propofol infusion to maintain the entropy values between 40 and 60. In the PCV mode, the inspiratory pressure was adjusted to obtain an expiratory tidal volume of 8 mL·kg-1 and a respiratory rate of 12-20/min. In the PSVPRO group, the flow trigger was set at 0.4 L·min-1 and pressure support was adjusted to obtain expiratory tidal volume of 8 mL·kg-1. Consumption of anesthetic agent was recorded as the primary outcome. Emergence time and discharge time were recorded as secondary outcomes. RESULTS The PSVPro group showed significant reduction in propofol consumption compared with the PCV group (mean difference, 33.3 µg-1·kg-1·min-1; 95% confidence interval [CI], 24.2 to 42.2). There was decrease in the emergence time in the PSVPro group compared with the PCV group (mean difference, 3.5 min; 95% CI, 2.8 to 4.2) and in time to achieve modified Aldrete score > 9 (mean difference, 3.6 min; 95% CI, 1.9 to 5.2). CONCLUSION The PSVPro mode decreases propofol consumption and emergence time, and improves oxygenation index in children undergoing ambulatory surgery. TRIAL REGISTRATION Clinical Trial Registry of India (CTRI/2017/12/010942); registered 21 December, 2017.

中文翻译:


与接受日间手术的儿童的压力控制通气相比,压力支持通气 Pro 可减少异丙酚消耗并改善术后氧合指数:一项随机对照试验。



目的 由于改善了呼吸机与患者的同步性并减少了呼吸功,PSVPro 模式越来越多地用于喉罩气道下的手术。我们假设与压力控制通气 (PCV) 相比,PSVPro 通气模式会减少麻醉剂的消耗。方法 70 名 3 至 8 岁接受择期下腹部和泌尿外科手术的儿童被随机分为 PCV 组(n = 35)或 PSVPro 组(n = 35)。使用七氟烷诱导全身麻醉并插入 Proseal LMA™。输注异丙酚维持麻醉,维持熵值在40~60之间。PCV模式下,调节吸气压力,使呼气潮气量为8 mL·kg-1,呼吸频率为12~20次/min。 PSVPRO组将流量触发设置为0.4 L·min-1,调整压力支持以获得8 mL·kg-1的呼气潮气量。麻醉剂的消耗被记录为主要结果。苏醒时间和出院时间被记录为次要结果。结果 与 PCV 组相比,PSVPro 组异丙酚消耗量显着减少(平均差为 33.3 µg-1·kg-1·min-1;95% 置信区间 [CI],24.2 至 42.2)。与 PCV 组相比,PSVPro 组的苏醒时间缩短(平均差,3.5 分钟;95% CI,2.8 至 4.2),并且达到改良 Aldrete 评分 > 9 的时间(平均差,3.6 分钟;95%) CI,1.9 至 5.2)。结论 PSVPro 模式减少了日间手术患儿的异丙酚消耗量和苏醒时间,并改善了氧合指数。试验注册 印度临床试验注册中心 (CTRI/2017/12/010942);注册日期:2017 年 12 月 21 日。
更新日期:2020-01-04
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