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PubMedDate not supplied

Frequency and severity of desaturation events during general anesthesia in children with and without upper respiratory infections.

STUDY OBJECTIVE: To determine whether anesthesia in the presence of a mild upper respiratory infection (URI) was associated with episodes of desaturation or reactive airway problems. DESIGN: A prospective study. SETTING: Inpatient and outpatient units of a university medical center. PATIENTS: Four hundred two pediatric patients. INTERVENTIONS: Patients were monitored with continuous recordings of oxygen saturation (SpO2), capnography, and electrocardiogram. A separate anesthesiologist was present throughout each case to observe for complications and interview the anesthesia team. The decision to anesthetize patients with a URI was left to the discretion of the anesthesia team. MEASUREMENTS AND MAIN RESULTS: Thirty patients with a URI and 372 patients without one were studied. One hundred ninety-six patients were managed with endotracheal intubation and 206 with face mask; 15 in each group had a URI. There was no increase in major desaturation events (SpO2 of 85% or less for 30 or more seconds) but minor desaturation events (SpO2 of 95% or less for 60 or more seconds) were increased (p = 0.02). There was no increased frequency of laryngospasm (1 in 30 vs. 22 in 372), but there was a higher frequency of bronchospasm in intubated patients (2 in 15 vs. 1 in 181; p = 0.016). CONCLUSIONS: Children with a mild URI have an increased frequency of minor desaturation episodes, and intubated patients with a URI have an increased frequency of bronchospasm. It appears that children with a mild URI may be safely anesthetized, since the problems encountered are generally easily treated and without long-term sequelae.

Anesthesia, General↗
PubMed2005

Acoustic reflectometry esophageal profiles minimally affected by massive gas ventilation.

Acoustic reflectometry can be used to distinguish between breathing tube placement in an esophagus vs the trachea via characteristic area-distance profiles for both cavities. In the cardiopulmonary resuscitation setting, capnography may be useless because the patient has little or no pulmonary circulation. With the breathing tube in the esophagus, can massive ventilation with a manual resuscitation bag, as might occur in the cardiopulmonary resuscitation setting, markedly alter the form of the obtained esophageal reflectometry profile? Nine hounds were induced, endotracheally intubated, mechanically ventilated, and anesthetized. Area-distance profiles were obtained with a 2-microphone acoustic reflectometer customized to measure areas up to 50 cm. Acoustic reflectometer profiles were obtained in intubated esophagi as follows: (1) baseline nonventilated state, (2) after aggressive 2-handed manual ventilation with high inspiratory pressures, rapid respiratory rates, and large tidal volumes for periods of 0.5, 1, and 1.5 minutes, upon detachment of the resuscitation bag, and (3) after esophagogastric decompression. We hypothesized that massive gas ventilation has no effect on the esophageal peak areas (null hypothesis), and used a paired t test for statistical significance (P < .05). For times of 0.5, 1.0, and 1.5 minutes, the ventilation volumes (mean +/- SD) were 25 +/- 7, 49 +/- 8, and 70 +/- 18 L. Massive gas ventilation caused minimal broadening and slight distal spread of the basal "hump". The mean peak area change was 0.18 +/- 0.35 cm2. For a paired t test (n = 9, df = 8), the corresponding t value was 1.54, with a P value of .16, which was incompatible with the null hypothesis. The experimental observations indicate a minimal effect of massive gas ventilation on the acoustic reflectometry esophageal profile. Hence, operator recognition of the altered canine acoustic reflectometer profile as that of an esophageal cavity is maintained, indicating that acoustic reflectometry may be useful in correctly identifying the site of breathing tube placement in out-of-hospital cardiac arrest situations despite massive esophageal ventilation.

Acoustics↗
PubMed2006

The impact of intraoperative monitoring on patient safety.

There is much more to study and learn about prevention of anesthesia complications and how technology may improve the safety and outcome of anesthesia. Large trials have never shown that a specific hemodynamic monitoring technique improves outcome. In controlled situations, oximetry and capnography have demonstrated efficacy in early detection of events that could be harmful during anesthesia. The BIS monitor has been shown to affect early recovery outcomes and possibly be of value in decreasing long-term mortality. Through all the controversy one thing remains constant: the response to information coming from monitors depends solely on the person administering the anesthesia. Aids to practitioner vigilance probably can never be proved to possess independent benefit, but their role in improving practitioner performance cannot be argued.

Anesthesia↗
PubMed2004

Life support for trauma and transport: a mobile ICU for safe in-hospital transport of critically injured patients.

BACKGROUND: In-hospital transport of newly injured patients is complicated by inadequate monitoring and adverse events. LSTAT (Life Support for Trauma and Transport, Integrated Medical Systems Inc) is a platform with multiple integrated systems (ventilator, defibrillator, suction, hemodynamic monitors, infusion and invasive monitoring channels, capnography, blood analysis, and electrocardiography) that allow seamless monitoring and effective life-saving interventions during transport. The platform functions as a mobile ICU and has preliminarily been tested with success in combat settings. This is the first evaluation of LSTAT in the civilian transport arena. STUDY DESIGN: Major trauma patients requiring trauma team activation, who were transported from the Emergency Department through different hospital departments (usually CT or angiography) to the ICU or operating room were included prospectively (December 2002 through April 2003). Patients were monitored and transported either by conventional means (conventional group) or by LSTAT (LSTAT group). Primary outcomes related to resource consumption and process of care; secondary outcomes related to clinical events. A questionnaire was completed by the surgeons participating in transports to document perceptions and preferences about means of in-hospital transport. RESULTS: Of 178 patients enrolled, 85 (48%) were in the LSTAT and 93 (52%) in the conventional groups. The two groups were similar except for age and mechanism of injury. Time of hand-bagging, preparation for transport, and return of blood results was significantly shorter in the LSTAT than in the conventional group (p < 0.001 for all). Significantly fewer LSTAT than conventional transports required more than one escorting physician (p < 0.001). Significantly more surveyed surgeons preferred LSTAT to conventional methods to transfer patients. There were no differences in adverse events, hospital stay, or mortality between the two groups. CONCLUSIONS: LSTAT emerges as a safe and convenient method of in-hospital transport. It allows uninterrupted monitoring, immediate response to physiologic changes, and reduction in human resource consumption. Process of care is improved. LSTAT's potential to improve clinical outcomes needs to be tested in different environments, including the prehospital setting.

Adolescent↗
PubMed2006

A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery.

STUDY OBJECTIVE: The purpose of this study is to determine the efficacy and safety of sedation/analgesia using a mixture of propofol, alfentanil, and lidocaine. DESIGN: A retrospective case review was undertaken. SETTING: This study took place at a university medical center. PATIENTS: Eighty-nine American Society of Anesthesiologists physical status 1, 2, and 3 adult patients undergoing ophthalmic surgery with regional block and monitored anesthesia care were studied. INTERVENTION: Six milliliters of propofol, 2 mL of alfentanil, and 2 mL of 2% lidocaine (6-2-2 mixture) were freshly mixed. The bolus dose was determined based on the patients' age: 5 microg/kg of alfentanil (and 0.3 mg/kg of propofol) for patients older than 75 years; the dose increased 1 mug/kg per 10-year decrease in age; and up to 9 microg/kg of alfentanil (0.54 mg/kg of propofol) for patients younger than 45 years. Regional block was performed at 1 minute after bolus completion. Blood pressure (BP), Sa(O2), electrocardiogram, capnography, clinical signs of sedation, responses to block, need for airway support, nausea and vomiting (N/V), pain due to propofol infusion, recall, and patient and surgeon satisfaction were recorded. MEASUREMENTS AND MAIN RESULTS: Seventy-eight percent of patients achieved analgesia and sedation without adverse response to the block. Twelve percent achieved good analgesia and sedation with only eyebrow movement upon needle insertion. Twenty-seven percent had respiratory depression but were able to follow commands and maintain adequate ventilation. Two percent had brief apnea alleviated by chin lift or jaw thrust. None had pain because of propofol infusion or N/V. Before sedation, average systolic BP was significantly increased (P < 0.0001) compared with baseline. After sedation and block, systolic BP decreased 6% from baseline (P < 0.005). CONCLUSION: Adjusted for age and weight, the dose of the 6-2-2 mixture met the sedation requirements for most patients. With a low incidence of need for airway support, no pain during infusion, and no N/V, this novel mixture of propofol, alfentanil, and lidocaine provided adequate analgesia and sedation as well as hemodynamic stability for ophthalmic surgery under regional block.

Adult↗
PubMed2005

Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation.

OBJECTIVE: LUCAS is a new device for mechanical compression and decompression of the chest during cardiopulmonary resuscitation (CPR). The aim of this study was to compare the efficacy of this new device with standard manual external chest compressions using cerebral cortical blood flow, cerebral oxygen extraction, and end-tidal CO2 for indirect measurement of cardiac output. Drug therapy, with adrenaline (epinephrine) was eliminated in order to evaluate the effects of chest compressions alone. METHODS: Ventricular fibrillation (VF) was induced in 14 anaesthetized pigs. After 8 min non-intervention interval, the animals were randomized into two groups. One group received external chest compressions using a new mechanical device, LUCAS. The other group received standard manual external chest compressions. The compression rate was 100 min(-1) and mechanical ventilation was resumed with 100% oxygen during CPR in both groups. No adrenaline was given. After 15 min of CPR, external defibrillatory shocks were applied to achieve restoration of spontaneous circulation (ROSC). Cortical cerebral blood flow was measured continuously using Laser-Doppler flowmetry. End-tidal CO2 was measured using mainstream capnography. RESULTS: During CPR, the cortical cerebral blood flow was significantly higher in the group treated with LUCAS (p = 0.041). There was no difference in oxygen extraction between the groups. End-tidal CO2, an indirect measurement of the achieved cardiac output during CPR, was significantly higher in the group treated with the LUCAS device (p = 0.009). Restoration of spontaneous circulation was achieved in two animals, one from each group. CONCLUSIONS: Chest compressions with the LUCAS device during experimental cardiopulmonary resuscitation resulted in higher cerebral blood flow and cardiac output than standard manual external chest compressions. These results strongly support prospective randomised studies in patients to evaluate this new device.

Animals↗
PubMed2006

Available ventilation monitoring methods during pre-hospital cardiopulmonary resuscitation.

High quality cardiopulmonary resuscitation (CPR) in the pre-hospital setting has been associated with improved survival rates during cardiopulmonary arrest (CPA). Recent documentation of hyperventilation associated deterioration in hemodynamics during CPR, suggests that guided or controlled ventilation strategies may contribute to improved hemodynamics and increased survival. This article briefly reviews the mechanical methods, advantages, and disadvantages of the available ventilation monitoring methods currently available for clinical use, with an emphasis on pre-hospital implementation. We recommend that more objective measurement of ventilation during CPR be performed, with emphasis on a strategy for measuring both attempted ventilation frequency (f) and delivered tidal volume (VT). The use of improved thoracic impedance pneumography and capnography are appealing for such monitoring because of the widespread availability, but modifications to existing software and clinical data compared to a clinical standard would be required before general acceptance is possible. Other methods listed may offer advantages over these in select circumstances.

Cardiopulmonary Resuscitation↗
PubMed1998

The effects of branched chain amino acid infusion on pain perception and plasma concentrations of monoamines.

Infusions of branched chain amino acids (BCAA) have been shown to have several CNS-mediated effects including antinociceptive action. We investigated the effects of BCAA infusion on pain perception, respiratory control, and plasma monoamine concentrations. Six healthy female volunteers were given in a double-blind, random, crossover design an 8-h infusion (1.75 ml/kg/h) of either (a) Ringers lactate, (b) conventional 4% amino acid solution, or (c) 4% BCAA solution with intervals of at least 48 h. Respiratory control was evaluated with continuous capnography. Pain perception was measured using dental dolorimetry for sharp pain, and pain transmitted by afferent C-fibers was evaluated with tourniquet test. Changes in vigilance were measured using critical flicker fusion technique. Evaluations were made for baseline, and after 2.5, 5, and 8 h. Plasma samples were collected at the same time points for amino acid and monoamine analysis. BCAA infusion resulted in significant increases of plasma concentrations of all BCAAs, with a simultaneous decrease in concentrations of aromatic amino acids. Of the measured monoamines and their metabolites dihydroxyphenylacetic acid (DOPAC) decreased, showing significant treatment effect for BCAA. Despite these changes no significant effect of BCAAs on respiratory control, vigilance, or pain perception was observed. In conclusion, despite significant changes in plasma concentrations of both amino acids and DOPAC, BCAA infusion did not show any clinically relevant antinociceptive effect.

3,4-Dihydroxyphenylacetic Acid↗
PubMed2002

Pulse oximetry and end tidal carbon dioxide monitoring.

Noninvasive monitoring of cardiopulmonary function through pulse oximetry and capnography provides immediate and important information for the clinician. These monitors are not a replacement for vigilant attention to the patient, however; they should be used in conjunction with arterial blood gas analysis and serial physical examinations to ensure that the continuous readings are accurate and make clinical sense.

Animals↗
PubMed1993

A comparison of chest compressions between mechanical and manual CPR by monitoring end-tidal PCO2 during human cardiac arrest.

STUDY OBJECTIVE: To compare the use of mechanical and manual chest compressions during cardiac arrest based on continuous monitoring of end-tidal PCO2 (PETCO2). DESIGN: Prospective, randomized, crossover design. SETTING AND PARTICIPANTS: Fifteen consecutive adults ranging in age from 33 to 78 years who presented in nontraumatic cardiac arrest to the emergency department of a large teaching hospital. INTERVENTIONS: Study protocols were begun late in the resuscitation after initial resuscitation attempts were unsuccessful. Patients received four alternating five-minute trials (two manual and two mechanical), being randomized to begin with either technique. Mechanical compressions were performed by a mechanical device at a compression depth of 2 in. Both mechanical and manual compressions were delivered at a rate of 80 with a ventilation delivered after every fifth compression. Persons performing manual CPR were experienced American Heart Association basic life support providers, and no person performed manual CPR more than once during the study period. No resuscitative drugs were administered during the study period. PETCO2 was monitored continuously; those performing manual CPR were blinded to the PETCO2 monitor. Data were analyzed with repeated-measures analysis of variance and Scheffé multiple comparisons with the alpha error rate set of .05. MEASUREMENTS AND RESULTS: Mean PETCO2 during mechanical CPR was 13.6 +/- 4.14 mm Hg compared with 6.9 +/- 2.42 mm Hg during manually performed CPR (P < .001), a difference of 97%. Average mechanical CPR PETCO2 was higher in all cases. No patient was resuscitated successfully. Capnography also indicated that most CPR providers were inconsistent in their chest compressions. CONCLUSION: This study suggests that cardiac output produced with mechanical chest compressions is greater than that produced with manual compressions as demonstrated by the significantly higher PETCO2 levels during mechanical CPR. Reasons for this are unclear. In addition, monitoring of PETCO2 may help optimize chest compressions during CPR.

Adult↗
PubMed1989

Capnographic waveforms in esophageal intubation: effect of carbonated beverages.

Capnography is a useful tool in differentiating tracheal from esophageal intubation. It may be an especially useful tool in emergency airway management by rescue squads or in the emergency department. However, in clinical practice the question has arisen as to whether prior ingestion of carbonated beverages can generate false-positive capnographic evidence of endotracheal intubation when in fact esophageal intubation has occurred. To answer this question, we compared the difference between tracheal and esophageal capnographic waveforms in dogs in the setting of recent ingestion of carbonated beverages. Esophageal capnographic recordings from three of five dogs undergoing esophageal ventilation were strikingly positive for exhaled carbon dioxide; however, the waveforms were significantly different from waveforms of tracheal ventilation. We conclude that esophageal intubation, after recent ingestion of carbonated beverages, may give false-positive waveforms suggestive of tracheal intubation. Rapidly diminishing CO2 concentrations, however, help differentiate esophageal from tracheal ventilation in this setting.

Animals↗
PubMed1994

Out-of-hospital quantitative monitoring of end-tidal carbon dioxide pressure during CPR.

STUDY OBJECTIVE: To assess the feasibility and potential usefulness of quantitative measurement of end-tidal carbon dioxide pressure (PETCO2) during out-of-hospital cardiac arrest. DESIGN: Emergency medical technician-paramedics (EMT-Ps) were instructed in the operation of a portable battery-powered capnograph, the sensor for which was attached to the endotracheal tube following intubation. This was a preliminary pilot study limited to defining feasibility and potential utility in a small group of patients. SETTING: City with population of 70,745 served by an advanced life support emergency medical services system. PARTICIPANTS: Initial group of four patients who experienced out-of-hospital cardiac arrest and who were treated by EMT-Ps trained in operation of the capnograph. INTERVENTIONS: As soon as possible following endotracheal intubation a mainstream sensor was connected to the endotracheal tube and digital and capnographic waveform data obtained for the remainder of the resuscitation. Data were stored in memory and subsequently retrieved for the entire event, with digital readings at eight-second intervals. RESULTS: Capnographic measurements were obtained immediately after endotracheal intubation in all four patients. The capnograph was operated without difficulty throughout the resuscitations. Changes in performance of chest compression or changes in cardiac rhythm were reflected immediately in changes in (PETCO2). Persistent excretion of carbon dioxide during pulselessness was observed in two patients, consistent with "pseudo-electromechanical dissociation." CONCLUSION: These preliminary pilot observations confirm the feasibility of quantitative capnography during out-of-hospital cardiac arrest and indicate that early institution of this noninvasive procedure may provide insight into pathophysiologic mechanisms such as pseudo-electromechanical dissociation and may also track changes in pulmonary blood flow during chest compressions or during spontaneous circulation.

Aged↗
PubMed1998

Severe ventilatory compromise due to gastric distention during pediatric cardiopulmonary resuscitation.

We describe a child in cardiac arrest with severe ventilatory compromise due to gastric distention. During cardiopulmonary resuscitation (CPR), positive pressure ventilation may lead to gastric insufflation because of decreased pulmonary compliance and decreased lower esophageal sphincter tone. Essentially, gas delivered will follow the path of least resistance, which may be to the stomach. In our patient, gastric distention precluded effective ventilation and gastric decompression relieved ventilatory compromise. The values and pitfalls of clinical evaluation and capnography are presented.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

[Polygraphic study during hyperpnea tests in elderly subjects (author's transl)].

The incidence of age on the frequency of post-hyperventilation apnea was studied in two randomly chosen distinct populations. The hyperpnea and ventilatory response were recorded during a standard E.E.G. tracing in 1 060 subjects by a thermistor and in 100 other subjects by pneumotachography and capnography. Post-hyperventilation frequency was determined for the two populations taken overall and then for subjects under and over 60 years of age. The results were compared with demographic data (sex, excess bodyweight coefficient, illness), and experimental conditions (alertness, recording technique). In the second population the mean ventilation per minute rate was calculated during a reference rest period and two successive hyperventilation tests. The frequency of post-hyperventilation apnea is higher before 60 years of age in the absence of variations in alertness and/or associated supramedullary lesions. Ventilatory response under 60 years of age is seen as a prolonged phase of hypoventilation. After 60 years of age, in the absence of apnea, ventilation returns immediately to its reference value, while in the presence of apnea the hypoventilatory phase observed is of brief duration and delayed. These results are discussed and compared to those in the published literature.

Aged↗
PubMed2003

Apnea associated with hypoxia in preterm infants: impact on cerebral blood volume.

The present study analyzed changes in cerebral blood volume (CBV) during apnea associated with hypoxia compared to apnea without hypoxia. Hypoxia was defined as pulsoxymetric oxygen saturation <80%>10 s. The employed technique was near infrared spectroscopy combined with electrocardiogram, electroocologram, pulsoxymetry, sidestream capnography and two respiratory effort sensors. In 24 preterm infants 44 incidences of apnea were analyzed. Two main patterns were observed: a significant decrease or a significant increase of CBV. In the 'CBV decrease' group deltaCBV was -55 microl/100 g brain in hypoxic apnea, and -62 microl/100 g brain in non-hypoxic apnea. In the 'CBV increase' group the rise of CBV above preapneic values was +50 microl/100 g brain in hypoxic apnea, and +47 microl/100 g brain in non-hypoxic apnea. Heart rate showed a significant decrease only in the 'CBV decrease' group. Endexpiratory CO(2) increased significantly 1 min after apnea. In conclusion, this study observed significant changes of CBV during apnea in preterm infants, but no difference in CBV behavior regarding whether incidents of apnea were associated with hypoxia or not. It remains unclear which regulatory mechanisms are responsible for the two observed patterns of deltaCBV during apnea.

Apnea↗
PubMed1999

[Fastrach laryngeal mask and difficult intubation].

OBJECTIVE: To evaluate the success rate of intubation through the intubating laryngeal mask airway (LMA-Fastrach) in patients with predictive signs of difficult airway or after intubation failure. STUDY DESIGN: Open prospective study. PATIENTS: The study included 33 adults, 21 with predictive signs of difficult airway and 12 after intubation failure. METHODS: After induction of anaesthesia, the intubating LMA was inserted. Proper insertion was confirmed by easy bag ventilation and capnography. Intubation through the intubating LMA was then carried out with an armoured endotracheal tube. If intubation failed, a second attempt was carried out after a gentle manipulation of the intubating LMA. After two attempts, if intubation remained impossible, fibrescopic intubation through the intubating LMA was carried out. In case of failure the usual tracheal intubation algorithms were used. RESULTS: Tracheal intubation through the intubating LMA was successful in all patients, in 32 on the first attempt and in one on the second. Successful tracheal intubation was possible on the first attempt in 25 patients (76%), on the second in four (12%) and after fibrescopic intubation through the intubating LMA in the four remaining (12%). CONCLUSION: The results of this study confirm that tracheal intubation through the intubating LMA can be recommended in patients with a difficult airway, whether foreseen or not.

Algorithms↗
PubMed2002

[Survey of anesthesia practice in Morocco].

OBJECTIVE: To estimate qualitatively and quantitatively the anaesthetic activity in Morocco to identify of the priorities and the norm to recommend. STUDY DESIGN: The investigation was realised from July 1999 to December 1999. It lasted seven days from Tuesday 8 PM to the following Tuesday 8 PM. A questionnaire was addressed to each hospital. One responsible has been chosen for each city. Data has been processed using the programming languages Microsoft Visual Basic. SETTING: All Moroccan's hospitals practicing anaesthesia: university hospitals (UH), public hospitals (PH), and private sector (PS). PATIENTS: All anaesthetic procedures realised by an anaesthetists; anaesthesia in medical office or dental surgery was excluded. RESULTS: An inventory of 2,630 anaesthesia was made. Anaesthesia distribution according to the type of hospitals was the same; PH = 35.7%, UH = 34.3% and PS = 29.96%. The preanaesthetic consultation was achieved in 47% of cases. Premedication was done in 28.5% of cases. General anaesthesia represented 3/4 of total anaesthesia. Thiopental was the drug the more frequently used. Gallamine and pethidine were still used in PH. Locoregional anaesthesia was realised in only 15% of cases. Electrocardioscopic surveillance not constant (65%), capnography almost absent in PH, pulse oximetry used in UH and PS. Ambulatory anaesthesia was used in 20% and emergency surgery in 30% of cases. CONCLUSION: Questioning about the Moroccan practice of anaesthesia is raised by this survey mostly because of drugs and monitoring use.

Adolescent↗
PubMed1991

[Anesthesia for heart catheterization in children. Comparison of 3 techniques].

A study was carried out to compare the haemodynamic and respiratory effects, as well as the quality of recovery, of anaesthesia with ketamine, sodium gamma-hydroxybutyrate (GOH) and etomidate in children undergoing cardiac catheterization. Thirty children, mean age 48 +/- 35 months, ranked ASA 2 or 3 on account of congenital heart disease, were assigned to one of three groups (n = 10). They were given: in group E1, a 0.3 mg.kg-1 bolus of etomidate, followed by 0.1 mg.kg-1.min-1 for 10 minutes, and 0.026 mg.kg-1.min-1 thereafter; in group G2, a 50 mg.kg-1 bolus of GOH, and in group K3, a 4 mg.kg-1 bolus of ketamine followed by a continuous infusion of 0.083 mg.kg-1.min-1. The patients breathed spontaneously. Monitoring included heart rate, systolic, diastolic and mean blood pressure, pulse oximetry, and capnography. Femoral venous or arterial catheterization was performed after local anaesthesia (with no more than 2 mg.kg-1 of lidocaine). Measurements were performed before induction, and then 1, 10, 30 and 60 minutes afterwards. The quality of anaesthesia was assessed according to Steward's scale. The investigation lasted between 50 and 100 min in all three groups. There were no significant differences in haemodynamic and respiratory parameters during the investigation between the groups. Recovery was shorter and of better quality in group E1. On the opposite, 30 minutes after the end of the catheterization, all the patients in group K3 were stuporous, with 5 of them displaying involuntary movements. The patients of the other two groups reacted correctly to stimuli, but those in group G2 went back to sleep very rapidly. There were no complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗