Impact of depth of propofol anaesthesia on functional residual capacity and ventilation distribution in healthy preschool children

Von Ungern-Sternberg, B. S., Frei, F. J., Hammer, J., Schibler, A., Doerig, R. and Erb, T. O. (2007) Impact of depth of propofol anaesthesia on functional residual capacity and ventilation distribution in healthy preschool children. British Journal of Anaesthesia, 98 4: 503-508. doi:10.1093/bja/aem002


Author Von Ungern-Sternberg, B. S.
Frei, F. J.
Hammer, J.
Schibler, A.
Doerig, R.
Erb, T. O.
Title Impact of depth of propofol anaesthesia on functional residual capacity and ventilation distribution in healthy preschool children
Journal name British Journal of Anaesthesia   Check publisher's open access policy
ISSN 0007-0912
1471-6771
Publication date 2007-04
Sub-type Article (original research)
DOI 10.1093/bja/aem002
Volume 98
Issue 4
Start page 503
End page 508
Total pages 6
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background Propofol is commonly used in children undergoing diagnostic interventions under anaesthesia or deep sedation. Because hypoxaemia is the most common cause of critical deterioration during anaesthesia and sedation, improved understanding of the effects of anaesthetics on pulmonary function is essential. The aim of this study was to determine the effect of different levels of propofol anaesthesia on functional residual capacity (FRC) and ventilation distribution.

Methods
In 20 children without cardiopulmonary disease mean age (sd) 49.75 (13.3) months and mean weight (sd) 17.5 (3.9) kg, anaesthesia was induced by a bolus of i.v. propofol 2 mg kg−1 followed by an infusion of propofol 120 µg kg−1 min−1 (level I). Then, a bolus of propofol 1 mg kg−1 was given followed by a propofol infusion at 240 µg kg−1 min−1 (level II). FRC and lung clearance index (LCI) were calculated at each level of anaesthesia using multibreath analysis.

Results The FRC mean (sd) decreased from 20.7 (3.3) ml kg−1 at anaesthesia level I to 17.7 (3.9) ml kg−1 at level II (P < 0.0001). At the same time, mean (sd) LCI increased from 10.4 (1.1) to 11.9 (2.2) (P = 0.0038), whereas bispectral index score values decreased from mean (sd) 57.5 (7.2) to 35.5 (5.9) (P < 0.0001).

Conclusions
Propofol elicited a deeper level of anaesthesia that led to a significant decrease of the FRC whereas at the same time the LCI, an index for ventilation distribution, increased indicating an increased vulnerability to hypoxaemia.
Keyword Anaesthetics i.v., propofol
Anaesthesia, paediatric
Lung, clearance index
Respiratory function, functional residual capacity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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