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. 1999 Oct;83(10):1131–1134. doi: 10.1136/bjo.83.10.1131

New equipment to prevent carbon dioxide rebreathing during eye surgery under retrobulbar anaesthesia

A Schlager 1, H Staud 1
PMCID: PMC1722816  PMID: 10502572

Abstract

BACKGROUND—Carbon dioxide concentration under ophthalmic drapes increases during eye surgery under local anaesthesia. A new prototype has been designed which combines continuous suction of carbon dioxide enriched air and continuous oxygen insufflation under ophthalmic drapes to prevent carbon dioxide accumulation in spontaneously breathing patients undergoing cataract surgery.
METHODS—In a prospective randomised single blind study the effectiveness of this new prototype was examined in 50 unpremedicated elderly patients. In 25 patients suction was applied under ophthalmic drapes, whereas in the other 25 patients no suction was used. In all cases oxygen was insufflated under the drapes at a constant flow of 2 l/min. Carbon dioxide concentration in the ambient air surrounding the patient's head under ophthalmic drapes, transcutaneous partial pressure of carbon dioxide, respiratory rate, and oxygen saturation were measured.
RESULTS—Carbon dioxide concentration under the drapes, transcutaneous partial pressure of carbon dioxide, and respiratory rate remained unchanged in the suction group, whereas in the non-suction group these values increased significantly. Oxygen saturation rose significantly in both groups without differences between the groups.
CONCLUSION—Application of this new prototype for continuous aspiration of carbon dioxide enriched air prevents carbon dioxide rebreathing and subsequent hypercapnia associated with an elevated respiratory rate. This new equipment may therefore be useful in patients undergoing ophthalmic surgery under retrobulbar anaesthesia.



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Figure 1  .

Figure 1  

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Design and position of the prototype during surgery: probe for measuring carbon dioxide and oxygen concentration under the drapes (A), suction tubes (B), and oxygen probe (C) in a model without drapes.

Figure 2  .

Figure 2  

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Delta values (mean (SD)) of carbon dioxide partial pressure (pCO2) under the drapes during cataract surgery under retrobulbar anaesthesia. Baseline values (BL) were measured before draping. Further values were measured after covering the head. Last measurement (post) was taken 5 minutes after removal of the drapes. * p<0.05, comparing the suction group and the non-suction group (unpaired t test).          

Figure 3  .

Figure 3  

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Delta values (mean (SD)) of transcutaneous measured pressure of carbon dioxide (ptcCO2) during cataract surgery under retrobulbar anaesthesia. Baseline values (BL) were measured before draping. Further values were measured after covering the head. Last measurement (post) was taken 5 minutes after removal of the drapes. * p<0.05, comparing the suction group and the non-suction group (unpaired t test).          

Figure 4  .

Figure 4  

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Delta values (mean (SD)) of respiratory rate (RR) during cataract surgery under retrobulbar anaesthesia. Baseline values (BL) were measured before draping. Further values were measured after covering the head. Last measurement (post) was taken 5 minutes after removal of the drapes. * p<0.05, comparing the suction group and the non-suction group (unpaired t test).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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