Beatrice Lim1, Dilip Pawar, Oriana Ng. 1. Department of Pediatrics Anesthesia, KK Women's and Children's Hospital, Singapore. limchinling@gmail.com
Abstract
AIM: To investigate the advantages of using pressure support ventilation (PSV) vs spontaneous ventilation via ProSeal™ laryngeal mask airway in children undergoing ambulatory surgery. BACKGROUND: In our ambulatory surgical unit, the use of unassisted spontaneous breathing via laryngeal mask airway is a common anesthetic technique during general anesthesia. However, this may be associated with inadequate ventilation. PSV is a ventilatory mode that is synchronized with the patient's respiratory effort and may improve gaseous exchange under general anesthesia. MATERIALS AND METHODS: After the approval from the ethics committee, a randomized controlled trial involving 24 pediatric patients was conducted in our ambulatory surgical unit. They were randomized into two groups, namely Group PSV (receiving PSV) and Group SV (unassisted spontaneous ventilation). Outcome measures included intraoperative respiratory and hemodynamic parameters as well as recovery room data. RESULTS: There were no significant differences in baseline characteristics between the two groups. Patients in Group PSV had lower ETCO(2) (42.8 ± 5.8 vs 50.4 ± 4.0, P = 0.001) and higher expiratory tidal volume per kg bodyweight (8.3 ± 1.8 ml kg(-1) vs 5.8 ± 0.8 ml kg(-1), P = 0.001) compared with patients in Group SV. There were no significant differences in other respiratory and hemodynamic parameters or recovery room data between the two groups. CONCLUSION:Pressure support ventilation via ProSeal™ laryngeal mask airway during general anesthesia improves ventilation in pediatric patients undergoing ambulatory surgery. However, this did not translate to a difference in clinical outcome among our study patients.
RCT Entities:
AIM: To investigate the advantages of using pressure support ventilation (PSV) vs spontaneous ventilation via ProSeal™ laryngeal mask airway in children undergoing ambulatory surgery. BACKGROUND: In our ambulatory surgical unit, the use of unassisted spontaneous breathing via laryngeal mask airway is a common anesthetic technique during general anesthesia. However, this may be associated with inadequate ventilation. PSV is a ventilatory mode that is synchronized with the patient's respiratory effort and may improve gaseous exchange under general anesthesia. MATERIALS AND METHODS: After the approval from the ethics committee, a randomized controlled trial involving 24 pediatric patients was conducted in our ambulatory surgical unit. They were randomized into two groups, namely Group PSV (receiving PSV) and Group SV (unassisted spontaneous ventilation). Outcome measures included intraoperative respiratory and hemodynamic parameters as well as recovery room data. RESULTS: There were no significant differences in baseline characteristics between the two groups. Patients in Group PSV had lower ETCO(2) (42.8 ± 5.8 vs 50.4 ± 4.0, P = 0.001) and higher expiratory tidal volume per kg bodyweight (8.3 ± 1.8 ml kg(-1) vs 5.8 ± 0.8 ml kg(-1), P = 0.001) compared with patients in Group SV. There were no significant differences in other respiratory and hemodynamic parameters or recovery room data between the two groups. CONCLUSION: Pressure support ventilation via ProSeal™ laryngeal mask airway during general anesthesia improves ventilation in pediatric patients undergoing ambulatory surgery. However, this did not translate to a difference in clinical outcome among our study patients.