New equipment to prevent carbon dioxide rebreathing during eye surgery under retrobulbar anaesthesia
A Schlager, Hubert Staud
Department of
Anaesthesia and General Intensive Care Medicine, Division of
Anaesthesia, The Leopold Franzens University of Innsbruck, Austria
Correspondence to: Dr Andreas Schlager, Department of Anaesthesia and General Intensive Care Medicine, Anichstrasse 35, A-6020 Innsbruck, Austria.
Accepted for publication 17 June 1999
BACKGROUND
Carbon
dioxide concentration under ophthalmic drapes increases during eye
surgery under local anaesthesia. A new prototype has been designed
which combines continuous suction of carbon dioxide enriched air and
continuous oxygen insufflation under ophthalmic drapes to prevent
carbon dioxide accumulation in spontaneously breathing patients
undergoing cataract surgery.
METHODSIn a
prospective randomised single blind study the effectiveness of this new
prototype was examined in 50 unpremedicated elderly patients. In 25 patients suction was applied under ophthalmic drapes, whereas in the
other 25 patients no suction was used. In all cases oxygen was
insufflated under the drapes at a constant flow of 2 l/min. Carbon
dioxide concentration in the ambient air surrounding the patient's
head under ophthalmic drapes, transcutaneous partial pressure of carbon
dioxide, respiratory rate, and oxygen saturation were measured.
RESULTSCarbon dioxide
concentration under the drapes, transcutaneous partial pressure of
carbon dioxide, and respiratory rate remained unchanged in the suction
group, whereas in the non-suction group these values increased
significantly. Oxygen saturation rose significantly in both groups
without differences between the groups.
CONCLUSIONApplication
of this new prototype for continuous aspiration of carbon dioxide
enriched air prevents carbon dioxide rebreathing and subsequent
hypercapnia associated with an elevated respiratory rate. This new
equipment may therefore be useful in patients undergoing ophthalmic
surgery under retrobulbar anaesthesia.
© 1999 by British Journal of Ophthalmology
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