Korean J Anesthesiol.  2007 Oct;53(4):470-476. 10.4097/kjae.2007.53.4.470.

The Effect of Doxapram Hydrochloride on the Ventilation Responses during Total Intravenous Anesthesia by Laryngeal Mask Airway

• Yoon YC
• Kwak SH
• Jeong ST
• Kim SJ
• Bae HB
• Chung SS
• Jeong CY

• KMID: 2236596
• DOI: http://doi.org/10.4097/kjae.2007.53.4.470

Abstract

BACKGROUND: Intravenous anesthetics causes depression of ventilatory response to hypercapnea. Doxapram stimulates ventilation via peripheral and central chemoreceptors. This study was aimed to evaluate the effect of doxapram on ventilation during total intravenous anesthesia (TIVA).
METHODS
60 patients undergoing operation under spontaneous ventilation via laryngeal mask airwaywere randomly divided into 3 groups: Control group received 5% dextrous infusion, D-2 group received doxapram injection of 1 mg/kg followed by continuous infusion of 2 mg/kg/hr, and D-4 group received doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr. Anesthesia was induced and maintained with propofol and remifentanil. Respiratory rate, tidal volume (VT) and arterial carbon dioxide tension (PaCO2) were measured before and 15 min after induction of anesthesia, 0(15 min after start of operation), 1, 2, 3, 5, 15, 30, 45, and 60 min after start of doxapram infusion during TIVA.
RESULTS
VT was significantly increased 1 min after start of doxapram infusion and returned to the value of pre-doxapram infusion immediately. In D-4 group, VT was significantly (P < 0.05) increased again 5 min after doxapram infusion compared with the value of pre-doxapram infusion and control group. PaCO2 was decreased 1 min after start of doxapram infusion and then increased again 2 min after doxapram infusion. In D-4 group, the degree of increase of PaCO2 was significantly (P < 0.05) less than those of D-2 group.
CONCLUSIONS
Doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr improved the depression of ventilatory response during TIVA.

Keyword

doxapram; respiratory depression; TIVA

MeSH Terms

Anesthesia
Anesthesia, Intravenous*
Anesthetics, Intravenous
Carbon Dioxide
Depression
Doxapram*
Humans
Laryngeal Masks*
Propofol
Respiratory Insufficiency
Respiratory Rate
Tidal Volume
Ventilation*
Anesthetics, Intravenous
Carbon Dioxide
Doxapram
Propofol