Improved Patient Recovery After Anesthesia With Hypercapnia Hyperpnoea

Not Applicable

Completed

Interventions: Device: Quick Emergence Device
Other: standard of care for phase one anesthesia care

Brief Summary: The proposed study will measure the time from the end of surgery until the time patients meet the discharge criteria from the postoperative anesthesia care unit and the time from the end of surgery until the patients regained cognitive function after anesthesia.

Detailed Description: Hypercapnia has been used in conjunction with hyperpnoea to provide a more rapid return of responsiveness after inhaled anesthesia. In our first clinical study with isoflurane we confirmed that the time from turning off the vaporizer to opening of eyes was shortened by an average of 62% when the minute ventilation was elevated and the end tidal carbon dioxide concentration was kept at 52 mmHg rather than 28 mmHg during emergence. In our second study we found that hypercapnia and hyperpnoea accelerated recovery proportionately for sevoflurane and desflurane. The benefits of accelerating subject recovery in the operating room may extend to the entire recovery period if the subject is more alert and easier to care for when they arrive in the post anesthesia care unit.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

a history of renal or hepatic disease,
chronic alcohol or drug abuse,
disabling neuropsychiatric disorder,
hypersensitivity or unusual response to other halogenated anesthetics,
pulmonary hypertension,
increased intracranial pressure,
seizure disorder
personal/familial history of malignant hyperthermia.
currently being treated with known hepatic enzyme-inducing drugs (e.g., phenobarbital, dilantin or isoniazid)
or with drugs known to alter anesthetic requirements (e.g., opiates, clonidine, alpha2 agonists, alcohol, anticonvulsants, antidepressants, barbiturates, benzodiazepines or other tranquilizers).
intolerance to non-steroidal anti-inflammatories.
have received general anesthesia within the previous 7 days,
received any investigational drug within the previous 28 days,
participated in a previous isoflurane or desflurane study
Female subjects can be neither pregnant nor breast feeding.

Arm && Interventions

Group	Intervention	Description
Phase 1 Recovery	Quick Emergence Device	Quick Emergence Device is in place for phase 1 anesthesia recovery
Standard of care	standard of care for phase one anesthesia care	Tidal volume and respiratory rate are not changed during phase 1 recovery from anesthesia

Primary Outcome Measures

Name	Time	Method
Recovery From Anesthesia	up to 2 hours	average time in minutes from the time the surgeon finished closing the surgical incision until the time the investigator in the postoperative care unit determined that the patients meet the discharge criteria from the postoperative anesthesia care unit (their vital signs had been stable for at least 30 min, their pain scores were less than the tolerable pain scores, they could sit up without dizziness or nausea, and their Aldrete score was ≥8).

Secondary Outcome Measures

Name	Time	Method
Return of Cognitive Function	up to 30 minutes	average time in minutes from the time the surgeon finished closing the surgical incision at the end of surgery until the patients could correctly state their full name, the current year and their day, month and year of birth