• Rita Katznelson, Adriaan Van Rensburg, Zeev Friedman, Marcin Wasowicz, George N Djaiani, Ludwik Fedorko, Leonid Minkovich, and Joseph A Fisher.
• Department of Anesthesia, Toronto General Hospital, Eaton North 3-453, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. rita.katznelson@uhn.on.c
• Anesth. Analg. 2010 Aug 1;111(2):403-8.

BackgroundWe conducted a prospective controlled clinical trial of the effect of isocapnic hyperpnoea (IH) on the times-to-recovery milestones in the operating room (OR) and postanesthetic care unit (PACU) after 1.5 to 3 hours of isoflurane anesthesia.MethodsThirty ASA grade I-III patients undergoing elective gynecological surgery were randomized at the end of surgery to either IH or the conventional recovery (control). Six patients with duration of anesthesia of <90 minutes were excluded from the analysis. The anesthesia protocol included propofol, fentanyl, morphine, rocuronium, and isoflurane in air/O(2). Unpaired t tests and analyses of variance were used to test for differences in times-to-recovery indicators between the two groups.ResultsThe durations of anesthesia in IH and control groups were 140.8 + or - 32.7 and 142 + or - 55.6 minutes, respectively (P = 0.99). The time to extubation was much shorter in the IH group than in the control group (6.6 + or - 1.6 (SD) vs. 13. 6 + or - 3.9 minutes, respectively; P < 0.01). The IH group also had shorter times to eye opening (5.8 + or - 1.3 vs. 13.7 + or - 4.5 minutes; P < 0.01), eligibility for leaving the OR (8.0 + or - 1.7 vs. 17.4 + or - 6.1 minutes; P < 0.01), and eligibility for PACU discharge (74.0 + or - 16.5 vs. 94.5 + or - 14.7 minutes; P < 0.01). There were no differences in other indicators of recovery.ConclusionIH accelerates recovery after 1.5 to 3 hours of isoflurane anesthesia and shortens OR and PACU stay.

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