Capnography and ventilatory assessment during ambulatory dentoalveolar surgery

Jeffrey Bennett, Troy Petersen, Joseph A. Burleson

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to determine whether capnography is a more sensitive monitor than auscultation of breath sounds in detecting ventilator/changes consistent with hypoventilation, obstruction, or apnea and in detecting ventilatory changes that can be associated with oxygen desaturation. Patients and Methods: Fifty-five patients received intravenous agents and supplemental oxygen to achieve a state of deep sedation or general anesthesia for removal of impacted third molars. The surgeon/anesthetist monitored respiratory status using a pretracheal stethoscope and direct observation. A blinded observer with no access to the patient or anesthetist monitored respirator/ status using capnography. A second observer monitored all respiratory parameters to allow for correlation between clinical and electronic monitors. Results: Ventilatory status was continuously represented by capnography. The Pearson correlation coefficient showed a positive correlation between increased end-tidal CO 2 (P(ET)CO 2) and decreased oxygen saturation that be-came stronger with greater positive changes in P(ET)CO 2. An additive relationship was found between P(ET)CO 2 and respiratory rate (RR), with increased P(ET)CO 2 and decreased RR contributing to decreased oxygen saturation. Conclusions: Patients with nasal ventilatory exchange maintain this exchange throughout the anesthesia so that sampling of nasal P(ET)CO 2 is an effective way to monitor ventilatory status. Respiratory depression or obstructive ventilatory changes detected by capnography showed a high sensitivity and low positive predictive value in detecting oxygen desaturation. The current technology does not show a clinically satisfactory correlation between P(ET)CO 2 and oxygen saturation. However, a combined increase in P(ET)CO 2 and decrease in RR suggested a trend of decreasing oxygen saturation.

Original languageEnglish (US)
Pages (from-to)921-925
Number of pages5
JournalJournal of Oral and Maxillofacial Surgery
Volume55
Issue number9
DOIs
StatePublished - Sep 1997
Externally publishedYes

Fingerprint

Capnography
Carbon Monoxide
Ambulatory Surgical Procedures
Oxygen
Respiratory Rate
Mechanical Ventilators
Nose
Deep Sedation
Stethoscopes
Auscultation
Hypoventilation
Third Molar
Apnea
Respiratory Insufficiency
General Anesthesia
Anesthesia
Observation
Technology

ASJC Scopus subject areas

  • Dentistry(all)
  • Surgery

Cite this

Capnography and ventilatory assessment during ambulatory dentoalveolar surgery. / Bennett, Jeffrey; Petersen, Troy; Burleson, Joseph A.

In: Journal of Oral and Maxillofacial Surgery, Vol. 55, No. 9, 09.1997, p. 921-925.

Research output: Contribution to journalArticle

Bennett, Jeffrey ; Petersen, Troy ; Burleson, Joseph A. / Capnography and ventilatory assessment during ambulatory dentoalveolar surgery. In: Journal of Oral and Maxillofacial Surgery. 1997 ; Vol. 55, No. 9. pp. 921-925.
@article{593156ba5adf4a74b4b571be3af41d3d,
title = "Capnography and ventilatory assessment during ambulatory dentoalveolar surgery",
abstract = "Purpose: The purpose of this study was to determine whether capnography is a more sensitive monitor than auscultation of breath sounds in detecting ventilator/changes consistent with hypoventilation, obstruction, or apnea and in detecting ventilatory changes that can be associated with oxygen desaturation. Patients and Methods: Fifty-five patients received intravenous agents and supplemental oxygen to achieve a state of deep sedation or general anesthesia for removal of impacted third molars. The surgeon/anesthetist monitored respiratory status using a pretracheal stethoscope and direct observation. A blinded observer with no access to the patient or anesthetist monitored respirator/ status using capnography. A second observer monitored all respiratory parameters to allow for correlation between clinical and electronic monitors. Results: Ventilatory status was continuously represented by capnography. The Pearson correlation coefficient showed a positive correlation between increased end-tidal CO 2 (P(ET)CO 2) and decreased oxygen saturation that be-came stronger with greater positive changes in P(ET)CO 2. An additive relationship was found between P(ET)CO 2 and respiratory rate (RR), with increased P(ET)CO 2 and decreased RR contributing to decreased oxygen saturation. Conclusions: Patients with nasal ventilatory exchange maintain this exchange throughout the anesthesia so that sampling of nasal P(ET)CO 2 is an effective way to monitor ventilatory status. Respiratory depression or obstructive ventilatory changes detected by capnography showed a high sensitivity and low positive predictive value in detecting oxygen desaturation. The current technology does not show a clinically satisfactory correlation between P(ET)CO 2 and oxygen saturation. However, a combined increase in P(ET)CO 2 and decrease in RR suggested a trend of decreasing oxygen saturation.",
author = "Jeffrey Bennett and Troy Petersen and Burleson, {Joseph A.}",
year = "1997",
month = "9",
doi = "10.1016/S0278-2391(97)90058-6",
language = "English (US)",
volume = "55",
pages = "921--925",
journal = "Journal of Oral and Maxillofacial Surgery",
issn = "0278-2391",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - Capnography and ventilatory assessment during ambulatory dentoalveolar surgery

AU - Bennett, Jeffrey

AU - Petersen, Troy

AU - Burleson, Joseph A.

PY - 1997/9

Y1 - 1997/9

N2 - Purpose: The purpose of this study was to determine whether capnography is a more sensitive monitor than auscultation of breath sounds in detecting ventilator/changes consistent with hypoventilation, obstruction, or apnea and in detecting ventilatory changes that can be associated with oxygen desaturation. Patients and Methods: Fifty-five patients received intravenous agents and supplemental oxygen to achieve a state of deep sedation or general anesthesia for removal of impacted third molars. The surgeon/anesthetist monitored respiratory status using a pretracheal stethoscope and direct observation. A blinded observer with no access to the patient or anesthetist monitored respirator/ status using capnography. A second observer monitored all respiratory parameters to allow for correlation between clinical and electronic monitors. Results: Ventilatory status was continuously represented by capnography. The Pearson correlation coefficient showed a positive correlation between increased end-tidal CO 2 (P(ET)CO 2) and decreased oxygen saturation that be-came stronger with greater positive changes in P(ET)CO 2. An additive relationship was found between P(ET)CO 2 and respiratory rate (RR), with increased P(ET)CO 2 and decreased RR contributing to decreased oxygen saturation. Conclusions: Patients with nasal ventilatory exchange maintain this exchange throughout the anesthesia so that sampling of nasal P(ET)CO 2 is an effective way to monitor ventilatory status. Respiratory depression or obstructive ventilatory changes detected by capnography showed a high sensitivity and low positive predictive value in detecting oxygen desaturation. The current technology does not show a clinically satisfactory correlation between P(ET)CO 2 and oxygen saturation. However, a combined increase in P(ET)CO 2 and decrease in RR suggested a trend of decreasing oxygen saturation.

AB - Purpose: The purpose of this study was to determine whether capnography is a more sensitive monitor than auscultation of breath sounds in detecting ventilator/changes consistent with hypoventilation, obstruction, or apnea and in detecting ventilatory changes that can be associated with oxygen desaturation. Patients and Methods: Fifty-five patients received intravenous agents and supplemental oxygen to achieve a state of deep sedation or general anesthesia for removal of impacted third molars. The surgeon/anesthetist monitored respiratory status using a pretracheal stethoscope and direct observation. A blinded observer with no access to the patient or anesthetist monitored respirator/ status using capnography. A second observer monitored all respiratory parameters to allow for correlation between clinical and electronic monitors. Results: Ventilatory status was continuously represented by capnography. The Pearson correlation coefficient showed a positive correlation between increased end-tidal CO 2 (P(ET)CO 2) and decreased oxygen saturation that be-came stronger with greater positive changes in P(ET)CO 2. An additive relationship was found between P(ET)CO 2 and respiratory rate (RR), with increased P(ET)CO 2 and decreased RR contributing to decreased oxygen saturation. Conclusions: Patients with nasal ventilatory exchange maintain this exchange throughout the anesthesia so that sampling of nasal P(ET)CO 2 is an effective way to monitor ventilatory status. Respiratory depression or obstructive ventilatory changes detected by capnography showed a high sensitivity and low positive predictive value in detecting oxygen desaturation. The current technology does not show a clinically satisfactory correlation between P(ET)CO 2 and oxygen saturation. However, a combined increase in P(ET)CO 2 and decrease in RR suggested a trend of decreasing oxygen saturation.

UR - http://www.scopus.com/inward/record.url?scp=0030930689&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030930689&partnerID=8YFLogxK

U2 - 10.1016/S0278-2391(97)90058-6

DO - 10.1016/S0278-2391(97)90058-6

M3 - Article

VL - 55

SP - 921

EP - 925

JO - Journal of Oral and Maxillofacial Surgery

JF - Journal of Oral and Maxillofacial Surgery

SN - 0278-2391

IS - 9

ER -