A capnography and transcutaneous CO2 profile of bariatric patients during early postoperative period after opioid-sparing anesthesia

Deng, Jin; Balouch, Maha; Mooney, Ashley; DuCoin, Christopher; Camporesi, Enrico M.

doi:10.1016/j.soard.2021.01.013

Cited by 3 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the presence of residual opioids and muscle relaxants, patients are at potential risk of developing respiratory depression, especially in elderly and obese patients. PtcCO 2 monitoring effectively reflects PaCO 2 levels and is more suitable for observing changes in CO 2 fluctuations over time so that we can take appropriate treatment measures [ 32 ]. For pediatric patients, the anesthesia has certain particularity.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs. end-tidal techniques

et al. 2023

View full text Add to dashboard Cite

Purpose The present study aimed to investigate the correlation between transcutaneous carbon dioxide partial pressure (PtcCO2) and arterial carbon dioxide pressure (PaCO2) and the accuracy of PtcCO2 in predicting PaCO2 during laparoscopic surgery in pediatric patients. Methods Children aged 2–8 years with American Society of Anesthesiologists (ASA) class I or II who underwent laparoscopic surgery under general anesthesia were selected. After anesthesia induction and tracheal intubation, PtcCO2 was monitored, and radial arterial catheterization was performed for continuous pressure measurement. PaCO2, PtcCO2, and end-tidal carbon dioxide partial pressure (PetCO2) were measured before pneumoperitoneum, and 30, 60, and 90 min after pneumoperitoneum, respectively. The correlation and agreement between PtcCO2 and PaCO2, PetCO2, and PaCO2 were evaluated. Results A total of 32 patients were eventually enrolled in this study, resulting in 128 datasets. The linear regression equations were: PtcCO2 = 7.89 + 0.82 × PaCO2 (r2 = 0.70, P < 0.01); PetCO2 = 9.87 + 0.64 × PaCO2 (r2 = 0.69, P < 0.01). The 95% limits of agreement (LOA) of PtcCO2 – PaCO2 average was 0.66 ± 4.92 mmHg, and the 95% LOA of PetCO2 – PaCO2 average was –4.4 ± 4.86 mmHg. A difference of ≤ 5 mmHg was noted between PtcCO2 and PaCO2 in 122/128 samples and between PetCO2 and PaCO2 in 81/128 samples (P < 0.01). Conclusion In pediatric laparoscopic surgery, a close correlation was established between PtcCO2 and PaCO2. Compared to PetCO2, PtcCO2 can estimate PaCO2 accurately and could be used as an auxiliary monitoring indicator to optimize anesthesia management for laparoscopic surgery in children; however, it is not a substitute for PetCO2. Registration number of Chinese Clinical Trial Registry ChiCTR2100043636.

show abstract

Section: Discussionmentioning

confidence: 99%

Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs. end-tidal techniques

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The risk of OIRD persists in the postoperative period and increases the risk of readmission and mortality (Jungquist et al, 2019). In a study of 64 patients in the PACU following bariatric surgery, capnography was found to be faster than transcutaneous CO 2 monitoring to detect respiratory apnea and detected apnea even when pulse oximetry was normal (Deng, Balouch, Mooney, Ducoin, & Camporesi, 2021). A blinded observational trial of 250 patients in the PACU undergoing elective surgery under general anesthesia found that capnography detected respiratory adverse events an average of 8 minutes earlier than standard monitoring with pulse oximetry (Chung, Wong, Mestek, Niebel, & Lichtenthal, 2020).…”

Section: Capnography For Postanesthesia Carementioning

confidence: 99%

Continuous Capnography for Early Detection of Respiratory Compromise During Gastroenterological Procedural Sedation and Analgesia

Tobin

2024

Gastroenterology Nursing

View full text Add to dashboard Cite

Gastroenterology nurses working across a variety of clinical settings are responsible for periprocedural monitoring during moderate to deep procedural sedation and analgesia (PSA) to identify signs of respiratory compromise and intervene to prevent cardiorespiratory events. Pulse oximetry is the standard of care for respiratory monitoring, but it may delay or fail to detect abnormal ventilation during PSA. Continuous capnography, which measures end-tidal CO2 as a marker of alveolar ventilation, has been endorsed by a number of clinical guidelines. Large clinical trials have demonstrated that the addition of continuous capnography to pulse oximetry during PSA for various gastroenterological procedures reduces the incidence of hypoxemia, severe hypoxemia, and apnea. Studies have shown that the cost of adding continuous capnography is offset by the reduction in adverse events and hospital length of stay. In the postanesthesia care unit, continuous capnography is being evaluated for monitoring opioid-induced respiratory depression and to guide artificial airway removal. Studies are also examining the utility of continuous capnography to predict the risk of opioid-induced respiratory depression among patients receiving opioids for primary analgesia. Continuous capnography monitoring has become an essential tool to detect early signs of respiratory compromise in patients receiving PSA during gastroenterological procedures. When combined with pulse oximetry, it can help reduce cardiorespiratory adverse events, improve patient outcomes and safety, and reduce health care costs.

show abstract

“…Many studies in recent years have demonstrated the beneficial role of pulse oximetry and quantitative end tidal CO2 monitoring to assess adequacy of oxygenation and ventilation. [ 46 47 48 ] Although individual facilities worldwide vary in strategy, a major consideration should be utilizing this affordable technology in these higher risk patients as a best practice standard.…”

Section: Postoperative Considerations In Patients With Obesitymentioning

confidence: 99%

The patient with obesity and super-super obesity: Perioperative anesthetic considerations

et al. 2022

View full text Add to dashboard Cite

Obesity is associated with increased morbidity and mortality related to many complex physiologic changes and the rise worldwide has had far ranging implications in healthcare. According to the World Health Organization, over 2.8 million people die each year from being overweight or obese. Patients who are obese often need surgical procedures or interventional pain procedures and are at higher risk of complications. Patients with super-super obesity are those with body mass index greater than 60 kg/m 2 and are at even greater risk for complications. The present investigation reviews epidemiology, pathophysiology, and anesthesia considerations for best practice strategies in managing these higher risk patients. Clinical anesthesiologists must utilize careful assessment and consultation in developing safe anesthesia plans. Improvements in technology have advanced safety with regard to airway management with advanced airway devices and in regional anesthesia with ultrasound-guided nerve blocks that can provide increased flexibility in formulating a safe anesthetic plan. As well, newer drugs and monitors have been developed for perioperative use to enhance safety in patients with obesity.

show abstract

A capnography and transcutaneous CO2 profile of bariatric patients during early postoperative period after opioid-sparing anesthesia

Cited by 3 publications

References 12 publications

Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs. end-tidal techniques

Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs. end-tidal techniques

Continuous Capnography for Early Detection of Respiratory Compromise During Gastroenterological Procedural Sedation and Analgesia

The patient with obesity and super-super obesity: Perioperative anesthetic considerations

Contact Info

Product

Resources

About