Acoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia

Abstract

Respiratory depression can occur during intravenous general anesthesia without tracheal intubation. A new acoustic method for respiratory rate monitoring, RRa (Masimo Corp., Tokyo, Japan), has been reported to show good reliability in post-anesthesia care and emergency units. The purpose of this study was to investigate the reliability of the acoustic method for measurement of respiratory rate during intravenous general anesthesia, as compared with capnography. Patients with dental anxiety undergoing dental treatment under intravenous anesthesia without tracheal intubation were enrolled in this study. Respiratory rate was recorded every 30 s using the acoustic method and capnography, and detectability of respiratory rate was investigated for both methods. This study used a cohort study design. In 1953 recorded respiratory rate data points, the number of detected points by the acoustic method (1884, 96.5 %) was significantly higher than that by capnography (1682, 86.1 %) (P < 0.0001). In the intraoperative period, there was a significant difference in the LOA (95 % limits of agreement of correlation between difference and average of the two methods)/ULLOA (under the lower limit of agreement) in terms of use or non-use of a dental air turbine (P < 0.0001). In comparison between capnography, the acoustic method is useful for continuous monitoring of respiratory rate in spontaneously breathing subjects undergoing dental procedures under intravenous general anesthesia. However, the acoustic method might not accurately detect in cases in with dental air turbine.

American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: Revisions

“…Although studies document the reliability and validity of the devices, there is weak evidence that acoustic respiratory rate monitoring by itself reduces adverse events (Yang et al, 2017). There is evidence that in studies of postoperative respiratory depression, episodes of oxygen desaturation occurred that were not detected by changes in respiratory rate (Kawanishi, Inoue, & Kawaguchi, 2017;Ouchi, Fujiwara, & Sugiyama, 2017). Authors recommended pairing the acoustic respiratory rate monitor with pulse oximetry for more sensitive detection of OIRD (McGrath, Pyke, & Taenzer, 2017).…”

Benefits and harms of capnography during procedures involving moderate sedation

“…We included a single study in the qualitative analysis but excluded it from the meta-analyses because the authors reported the data differently than in the other included studies. 22 Of the 8 excluded articles, 1 was excluded because it was available only in Spanish, 23 3 were excluded because the investigators compared capnography with a nonstandard comparison group, [24][25][26] 2 were excluded because they were not clinical studies, 27,28 and 2 were excluded because they enrolled pediatric patients. 29,30 The single study involving dental treatment 26 was among those we excluded because it had a nonstandard comparison group.…”

Noninvasive Acoustic Respiration Rate Monitoring

“…Previous study reported that adult patients with dental anxiety undergoing dental treatment under intravenous anesthesia without tracheal intubation were studied [1]. In this report, 11 patients with age of mean 38 years were enrolled.…”

“…A new acoustic method for respiratory rate monitoring (RRa ® , Masimo Corp.) has shown good reliability when used in patients without tracheal intubation in dental operating room [1], postanesthesia care units [2,3], intensive care units [4], and emergency units [5]. Because there is no 'gold standard' for measurement of respiration rate, these reports were compared acoustic monitor with widely used methods (capnography or thoracic impedance pneumography).…”