Utility of capnography in predicting venous carbon dioxide partial pressure in sedated patients during outpatient oral surgery

Prstojevich, Steven J.; Sabol, Stephen R.; Goldwasser, Michael S.; Johnson, Calvin H.

doi:10.1016/0278-2391(92)90192-3

Cited by 21 publications

(8 citation statements)

References 2 publications

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“…[7][8][9] End-tidal CO 2 has been shown to detect airway obstruction more quickly than pulse oximetry. 22 Nasal-sample ETCO 2 has been shown to correlate well with blood partial pressure of carbon dioxide (pCO 2 ) in patients with unobstructed airways, 24 while airway obstruction and hypoventilation have been shown to produce ETCO 2 values that are lower than blood values. 23 Therefore, a patient with no airway obstruction or RD should have no change in the ETCO 2 .…”

Section: Discussionmentioning

confidence: 99%

Bispectral Electroencephalographic Analysis of Patients Undergoing Procedural Sedation in the Emergency Department

Miner

Biros

Heegaard

et al. 2003

Academic Emergency Medicine

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Objective: To determine whether there is a correlation between the level of sedation achieved during procedural sedation (PS) in the emergency department as determined by bispectral electroencephalographic (EEG) analysis (BIS) and the rate of respiratory depression (RD), the patient's perception of pain, recall of the procedure, and satisfaction. Methods: This was a prospective observational study conducted in an urban county hospital of adult patients undergoing PS using propofol, methohexital, etomidate, and the combination of fentanyl and midazolam. Consenting patients were monitored by vital signs, pulse oximetry, nasal-sample end-tidal carbon dioxide (ETCO 2 ), and BIS monitors during PS. Respiratory depression (RD) was defined as an oxygen saturation \90%, a change from baseline ETCO 2 of [10 mm Hg, or an absent ETCO 2 waveform at any time during the procedure. After the procedure, patients were asked to complete three 100-mm visual analog scales (VASs) concerning their perception of pain, recall of the procedure, and satisfaction with the procedure. Patients were divided into four groups based on the lowest BIS score recorded during the procedure, group 1, [85; group 2, 70-85; group 3, 60-69; group 4, \60. Rates of RD and VAS outcomes were compared between groups using chi-square statistics. Results: One hundred eight patients were enrolled in the study. No serious adverse events were noted. RD was seen in three of 14 (21.4%) of the patients in group 1, seven of 34 (20.6%) in group 2, 16 of 26 (61.5%) in group 3, and 18 of 34 (52.9%) in group 4. The rate of RD in patients in group 2 was not significantly different from that in group 1 (p ¼ 0.46). The rate of RD in group 2 was significantly lower than that in groups 3 (p ¼ 0.0003) and 4 (p ¼ 0.006). For the VAS data, when group 1 was compared with the combined groups 2, 3, and 4, it had significantly higher rates of pain (p ¼ 0.003) and recall (p ¼ 0.001), and a dissatisfaction rate (p ¼ 0.085) that approached significance. When groups 2, 3, and 4 were compared with chi-square test, there was not a significant difference in pain (p ¼ 0.151), recall (p ¼ 0.27), or satisfaction (p ¼ 0.25). Conclusions: Patients with a lowest recorded BIS score between 70 and 85 had the same VAS outcomes as more deeply sedated patients and the same rate of RD as less deeply sedated patients. This range of scores represented the optimally sedated patients in this study.

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Section: Discussionmentioning

confidence: 99%

Bispectral Electroencephalographic Analysis of Patients Undergoing Procedural Sedation in the Emergency Department

Miner

Biros

Heegaard

et al. 2003

Academic Emergency Medicine

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“…Although a capnometer would more readily identify a patient experiencing an apneic episode, the calculated doses of propofol used in our study never caused de-saturation requiring mechanical ventilation; therefore, pulse oximetry may be sufficient for the detection of hypoxia. However, a capnometer is a non-invasive method for measuring respiratory activity, and we are currently investigating whether carbon dioxide monitoring is desirable [33].…”

Section: Discussionmentioning

confidence: 99%

Safe and effective sedation in endoscopic submucosal dissection for early gastric cancer: a randomized comparison between propofol continuous infusion and intermittent midazolam injection

Kiriyama

Gotoda²,

Sano

et al. 2010

J Gastroenterol

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“…In den anerkannten Über-sichtsarbeiten besteht Einigkeit, dass EKG mit Herzfrequenz, nicht-invasiv gemessener Blutdruck und v. a. die Sauerstoffsättigung bei einer fiberoptischen Intubation zwingend erforderlich sind [2,8,13] [3,22]. Es wurde zwar gezeigt, dass die angezeigten nasalen CO 2 -Werte tiefer liegen als die CO 2 -Werte bei intubierten Patienten [3,16], die Differenz zwischen dem nasal-endtidalen und dem arteriellem CO 2 also größer ist als bei der endtidalen Messung intubierter Patienten. Dieser Unterschied spielt bei der relativ kurzen Dauer einer fiberoptischen Intubation jedoch eine untergeordnete Rolle, da bekanntlich bei stabiler Oxygenierung eine Hyperkapnie für einen Zeitraum von weit über 10 min ohne Nachteil für den Patienten tolerabel ist [9,11].…”

Section: Monitoringunclassified

“…Die Untersucher bedienten sich dabei nasaler O 2 -Brillen, die sie in Anlehnung an Goldmann[6] nach Durchstechen mit einer16-Gauge i.v.-Kanüle und Entfernen des Metallstiletts an die Seitenstromkapnographie anschlossen. So konnten Bradypnoen bzw.…”

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Bronchoskopische Intubation in Remifentanil-Propofol-Sedierung

2001

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Utility of capnography in predicting venous carbon dioxide partial pressure in sedated patients during outpatient oral surgery

Cited by 21 publications

References 2 publications

Bispectral Electroencephalographic Analysis of Patients Undergoing Procedural Sedation in the Emergency Department

Bispectral Electroencephalographic Analysis of Patients Undergoing Procedural Sedation in the Emergency Department

Safe and effective sedation in endoscopic submucosal dissection for early gastric cancer: a randomized comparison between propofol continuous infusion and intermittent midazolam injection

Bronchoskopische Intubation in Remifentanil-Propofol-Sedierung

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