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Ventilatory Responses to Hypercapnia during Bupivacaine Spinal Anesthesia

Department of Anesthesia, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Abstract

The effect of spinal anesthesia with isobaric 0.5% bupivacaine on ventilatory responsiveness to CO₂ rebreathing was Studied in ten unpremedicated patients. Minute ventilation (E) at end-tidal PCO₂ = 55 mm Hg increasedfrom 18.7 ± 6.7 L/min (mean ± SD) to 22.3 ± 10.1 L/min after induction of spinal anesthesia (P < 0.05). Occlusion pressure (P_0.1) at PCO₂ = 55 mm Hg also increased, from 3.8 ± 1.5 to 5.0 ± 1.7 cm H₂O (P <0.05). Spinal anesthesia was not associated with significant changes in vital capacity, maximal inspiratory pressure, resting end-tidal PCO₂, or the slopes or intercepts of the lines relating VE or P_0.1 to PCO₂. Theseresults show an increased ventilatory responsiveness to CO₂ with bupivacaine spinal anesthesia.

Key Words: ANESTHETIC TECHNIQUES—spinal • ANESTHETICS, LOCAL—bupivacaine • VENTILATION—carbon dioxide response

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999