Responses of respiratory drive and breathing pattern to inspiratory loading during nitrous oxide and isoflurane sedation.

BACKGROUND

Increased inspiratory resistance in combination with mild gas narcosis is common during recovery after a general anesthesia, but there are only few previous studies on inspiratory loading during subanesthetic gas narcosis.

METHODS

Responses of respiratory drive (central inspiratory activity, P0.1) and ventilatory pattern to an inspiratory threshold load of -6 cm H2O were studied in 16 healthy subjects during mild subanesthetic gas narcosis. One group (n = 9) was exposed to 13, 26 and 39% nitrous oxide (N2O) and air control (Group N). Another group (n = 7) was exposed to 0.1, 0.2 and 0.3% isoflurane and air control (Group I). Measurements were done after 1 min adaptation to the load.

RESULTS

Nitrous oxide and isoflurane had no effect on respiratory drive and VT either during unloaded breathing or during inspiratory threshold loading. Across all gas concentrations (including 0% control), inspiratory threshold loading resulted in significant P0.1 increases, amounting to 62% in group N and 38% in group I. At the same time VT decreased by 11 and 12%, respectively. A significantly increased end-expired CO2 and decreased minute volume compared to air control was found during isoflurane inhalation but could be ascribed to normalization of the hyperventilation in the control situation.

CONCLUSIONS

It is concluded that the steady-state ventilatory responses to loading, consisting of increased P0.1 and decreased VT, are maintained during inhalation of subanesthetic doses of N2O (0.13-0.38 MAC) and isoflurane (0.09-0.26 MAC).