| Title | The effects of different analgesic regimens on transcutaneous CO2 after major surgery. | | Author(s) | McCormack JG, Kelly KP, Wedgwood J, Lyon R | | Institution | Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Royal Infirmary, Edinburgh, EH16 4SA. | | Source | Anaesthesia 2008 Aug; 63(8):814-21. | | MeSH | Adult
Aged
Aged, 80 and over
Analgesia, Patient-Controlled
Analgesics
Analgesics, Opioid
Blood Gas Monitoring, Transcutaneous
Carbon Dioxide
Female
Humans
Intestine, Large
Male
Middle Aged
Monitoring, Physiologic
Partial Pressure
Postoperative Care
Respiration
Respiratory Insufficiency
| | Abstract | Ventilatory impairment may be detected by a rise in transcutaneous carbon dioxide levels (PtcCO(2)). This observational study assessed the clinical utility of PtcCO(2) monitoring in the postoperative period, and quantified the effect of different peri-operative analgesic regimens on postoperative respiratory function. Following pre-operative baseline PtcCO(2) recording, continuous PtcCO(2) monitoring was performed in 30 patients after major colorectal surgery for up to 24 h. Mean postoperative values of PtcCO(2) were 1.3 kPa (95% CI 1.0-1.5) higher than pre-operative values (p < 0.001). Patients receiving intravenous opioid patient controlled analgesia had a significantly higher elevation in postoperative PtcCO(2) compared to patients receiving epidural infusion analgesia, 1.8 kPa (CI 1.5-2.1) vs 0.7 kPa (CI 0.5-0.9) respectively (p < 0.001). The mean rise in PtcCO(2) following a single intravenous bolus of morphine delivered via PCA was 0.05 kPa (SEm 0.01), peaking at 12 min post-dose. The transcutaneous capnometer successfully recorded data for 98% of the total time it was applied to patients. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 18699897 |
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