Does pressure support ventilation improve the postoperative outcome of adeno-tonsillectomy patients? A prospective randomized trial

Abdelwahab, Hisham H.; Omar, Ahmed Mohammed; Abushanab, Ossama Hamed

doi:10.1016/j.egja.2012.02.002

Does pressure support ventilation improve the postoperative outcome of adeno-tonsillectomy patients? A prospective randomized trial

Authors

10.1016/j.egja.2012.02.002

Abstract

Background
Spontaneous ventilation (SV) is used for adeno/tonsillectomy in children. However, inhalational anesthetics produce dose dependent decrease in minute ventilation. We tested the impact of PSV on awakening time, and length of PACU stay.
Methods
34 patients were randomized into two groups; PS ventilation group and SV group. Premedication and induction were similar in both groups. Patients in PS group were ventilated with set to deliver 8 ml/kg , keeping ETCO between 35 and 45 mmHg. Any episodes of hypoventilation were recorded and corrected by manual support of ventilation.
Results
Extubation time (min) [mean (SD)] was longer in SV group than PS group [ () vs. (), < ]. In the SV group 9 patients had episodes of hypoventilation that necessitated manual assist of ventilation. Pain scores were higher in SV group than PS group. Duration of stay in PACU [mean (SD)] in minutes was longer in SV group than PS group [() vs. (), = ]. All but one patient in the PS group needed postoperative rescue meperidine analgesia. The mean (SD) time needed for rescue meperidine analgesia was () in PS group and () in SV group ( = )
Conclusion
PSV carries the advantages of overcoming the effects of narcotics and inhaled anesthetics on spontaneously ventilated adeno-tonsillectomy patients. They suffer less pain and spend less time in the PACU.

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