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Anesth Analg 1988; 67:656-662
© 1988 International Anesthesia Research Society
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Respiratory Mechanics and Intrinsic PEEP during Ketamine and Halothane Anesthesia in Young Children

David L. Shulman, MD, Ephraim Bar-Yishay, PhD, and Simon Godfrey, MD

Received from the Department of Anesthesia and Pediatrics and the Pulmonary Function Laboratory, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.

Abstract

Static compliance of the respiratory system (Crs) was measured by the interrupter technique in 18 anesthetized children to compare the effects of ketamine on Crs with those of halothane. Crs was the slope of the pressure-volume (P-V) curve obtained by repeated brief airway occlusions throughout relaxed expiration, and the intercept of the P-V curve on the pressure axis was the intrinsic positive end-expiratory airway pressure (PEEPi). Expiratory time (Te) was measured during a period of quiet breathing, and the passive expiratory time constant ({tau}) was measured during the relaxed expiration after an end-inspiratory occlusion. Nine children were anesthetized with a continuous infusion of ketamine and a matching group of nine children inhaled halothane in oxygen. Crs was significantly greater in the ketamine group (22.8 ± 6.2 ml/cm H2O) than in the halothane group (15.7 ± 5.5 ml/cm H2O). The {tau} value was also significantly greater in the ketamine group. Mean PEEPi in the ketamine group was 2.3 ± 1.8 cm H2O and in the halothane group was 0.4 ± 0.8 cm H2O. PEEPi correlated inversely with Te/{tau} according to a logarithmic function. It was concluded that, in children anesthetized with ketamine, Crs is significantly greater than that in children anesthetized with halothane, and the resultant prolongation of ± and decreased Te/{tau} with ketamine anesthesia lead to increased PEEPi.

Key Words: ANESTHESIA—pediatric • LUNG, MECHANICS—positive end-expiratory pressure • ANESTHETICS, INTRAVENOUS—ketamine • ANESTHETICS, VOLATILE—halothane






Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.