Abstract
The pattern of respiration in infants during anaesthesia is not well documented. In this study, minute ventilation (MV) during elective mask halothane anaesthesia (HA) was measured during spontaneous ventilation in infants (Group I) and children (Group II). Airflow was measured with pneumotachography (#0 Fleisch in Group I and #1 Fleisch in Group II). Analogue signals of pressure and flow were recorded on magnetic tape for off-line playback. The flow signal was mathematically integrated to volume. The surgical procedure was divided into three stages: A, B and C representing HA, surgical stimulation and emergence respectively. The pattern of respiration during spontaneous ventilation was described as tidal volume (VTX), respiratory frequency (fX), mean inspiratory flow (VT/TIX), inspiratory duty cycle (TI/ TTotX) where the subscript ξ denoted the stage. Seven infants (2.7 ± 0.5 mo, 5.8 ± 0.5 kg) and five children (3.1 ±1.1 yr, 15.8 ±1.7 kg) were studied. There was no difference in MV between Groups I and II. Halothane anaesthesia in both groups was characterized by rapid shallow breathing: VTA was lower in Group I (2.90 ± 0.8 ml · kg−1) than in Group II (3.74 ± 0.40 ml · kg−1) (P < 0.05). Tidal volume was lower during anaesthesia than emergence in both groups (P < 0.05). There was no difference in VT/TIX between groups. The VT/TIA was lower than VT/TIC in Group I (P < 0.05) but not in Group II. There was no intra or intergroup difference in TI/TTot between stages. We suggest that during HA infants have a greater reduction in VT than children, which may predispose infants to hypercarbia during HA.
Résumé
Les caractéristiques ventilatoires du nourisson pendant l’anesthésie sont mal définies. Au cours de la présente étude, la ventilation-minute (MV) pendant l’anesthésie à l’ halothane (HA) au masque pour chirurgie non urgente est mesurée sous ventilation spontanée chez des nourissons (groupe I) et des enfants (groupe II). Le débit respiratoire est mesuré par pneumotachographie (Fleisch #0 pour le groupe I, Fleisch #1 pour le groupe II). L’affichage analogique de la pression et du débit est enregistré sur ruban magnétique pour analyse ultérieure. Le signal du débit respiratoire est intégre mathématiquement à celui du volume. L’intervention chirurgicale est divisée en trois stages: A, B, et C lesquels représented respectivement: HA, la stimulation chirugicale et la période du réveil. Les variables propres à la ventilation spontanée comprennent le volume courant (VTX), la fréquence respiratoire (fx), le débit inspiratoire moyen (VT/TIX) et la durée du cycle inspiratoire (TI/ TTotX) où l’indice X correspond au stage. Sept nourissons (2, 7 ± 0,5 mois, 5,8 ± 0,5 kg) et cinq enfants (3,1 ± 1,1 ans, 15,8 ± 1,7 kg) font partie de l’ étude. On ne retrouve pas de différence de MV entre les groupes I et II. L’anesthésie à l’ halothane est caractérisée dans les deux groupes par une respiration superficielle rapide; le VTA est plus bas dans le groupe I (2,90 ± 0,8 ml · kg−1) que dans le groupe II (3,74 ± 0,40 ml · kg−1) (P < 0,05). Le volume courant est moins élevé pendant l’anesthésie qu’ à la période de réveil dans les deux groupes (P < 0,05). Il n’y a pas de différence pour le rapport (VT/ TIX) entre les groupes. Le VT/TIA est inférieur au VT/ TIC dans le groupe I (P < 0,05) mais non dans le groupe II. II n’y a pas de différences à l’ intérieur d’un groupe ou entre les groupes pour le TI/ TTot si on compare les stages. Ces résultats suggèrent que pendant HA, les nourissons subissent une plus grande réduction du VT que les enfants, ce qui pent prédisposer les nourissons à l’ypercarbie sous anesthésie spontanée à l’halothane.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Abbreviations
- fX :
-
Respiratory frequency
- MVX :
-
Minute ventilation (VT/TIX × TI/TTotX × 60)
- TEX :
-
Expiratory time
- TIX :
-
Inspiratory time
- TI/TTotX :
-
Inspiratory duty cycle
- TTotX :
-
total time of a respiratory cycle (TI + TE = TTot)
- VTX :
-
Tidal volume
- VT/TIX :
-
Mean inspiratory flow
- PETCO2 :
-
End tidal partial pressure CO2
References
Wren WS, Allen P, Synnot A, O’Keeffe D, O’Gniofa P. Effects of halothane, isoflurane and enflurane on ventilation in children. Br J Anaesth 1987; 59: 399–409.
Murat I, Chaussain M, Hamza J, Saint-Maurice C. The respiratory effects of isoflurane, enflurane and halothane in spontaneously breathing children. Anaesthesia 1987; 42: 711–8.
Lindahl SGE, Hulse MG, Hatch DJ. Ventilation and gas exchange during anaesthesia and surgery in spontaneously breathing infants and children. Br J Anaesth 1984; 56: 121–8.
Lindahl SGE, Yates AP, Hatch DJ. Respiratory depression in children at different end tidal halothane concentrations. Anaesthesia 1987; 42: 1267–75.
Ing AB, de Goede J, Olievier CN, Quanjer H. Sites of action of halothane on respiratory pattern and ventilatory response to CO2 in Cats. Anesthesiology 1982; 57: 389–98.
Tabatabai M, Kitahata LM, Yuge O, Matsumoto M, Collins JG. Effects of halothane on medullary inspiratory neurons of the cat. Anesthesiology 1987; 66: 176–80.
Milic-Emili J, Zin WA. Relationship between neuromuscular respiratory drive and ventilatory output.In: Handbook of Physiology. The Respiratory System Chp 49. Bethesda MD: Am Physiol Soc 1986; 35: 631–46.
Stahl WR. Scaling of respiratory variables in mammals. J Appl Physiol 1967; 22: 453–60.
Boggs DF, Tenney SM. Scaling respiratory pattern and respiratory “drive”. Respir Physiol 1984; 58: 245–51.
Cohen J. Statistical Power Analysis For The Behavioral Sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates Publishers, 1988.
Radford EP. Ventilation standards for use in artificial respiration. J Appl Physiol 1955; 7: 451–60.
Haddad GG, Epstein MAF, Leistner HL, Marino PA, Mellins RB. Maturation of ventilation and ventilatory pattern in normal sleeping infants. J Appl Physiol 1979; 46: 998–1002.
Gregory GA, Eger EL, Munson ES. The relationship between age and halothane requirement in man. Anesthesiology 1969; 30: 488–91.
Lerman J, Robinson S, Willis MM, Gregory GA. Anesthetic requirements for halothane in young children 0–1 month and 1–6 months of age. Anesthesiology 1983; 59: 421–4.
Nicodemus HF, Nassini-Rahimi C, Bachman L, Smith TC. Median effective doses (ED50) of halothane in adults and children. Anesthesiology 1969; 31: 344–8.
Brandom BW, Brandom RB, Cook DR. Uptake and distribution of halothane in infants: in vivo measurements and computer simulations. Anesth Analg 1983; 62: 404–10.
Milic-Emili J, Grunstein MM. Drive and timing components of ventilation. Chest 1976; 70: 131–3.
Benchetrit G, Shea SA, Baconnier PF, Dinh TP, Guz A. In favour of an “holistic” approach to the analysis of the pattern of breathing.In: GD Swanson, FS Grodlins, RL Hughson (Eds.). Respiratory Control A Modeling Perspective. Plenum Press 1989: 417–21.
Derrene JP, Coutur J, Iscoe S, Whitelaw WA, Milic-Emili J. Occlusion pressures in men rebreathing CO2 under methoxyflurane anaesthesia. J Appl Physiol 1976; 40: 805–14.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Brown, K.A., Bissonnette, B., Holtby, H. et al. Minute ventilation during mask halothane anaesthesia in infants and children. Can J Anaesth 40, 112–118 (1993). https://doi.org/10.1007/BF03011306
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03011306