Drive and timing components of respiration in young children following induction of anaesthesia with halothane or ketamine

Abstract

Timing and drive components of respiration were studied in 18 young children following induction of anaesthesia with ketamine and were compared with results from ten children following induction of anaesthesia with halothane. During one minute of quiet breathing, signals from a pneumotachograph attached to the anaesthetic mask were analysed for tidal volume (Vt), respiratory frequency (f), minute volume (Ve), inspiratory and expiratory times (Ti, Te) and flow pattern. Following induction of anaesthesia with ketamine, children breathed more slowly and deeply than children receiving halothane, but there was no significant difference in Ve or in Vt/Ti, suggesting that respiratory drive was similar in the two groups of children. In the children receiving ketamine, Ti was more than twice as long, and thus the ratio Ti/Te was significantly increased, in comparison with the group receiving halothane. In addition to the prolonged Ti in the children induced with ketamine, there was a more rapid increase in volume in early inspiration than in late inspiration, which is an apneustic breathing pattern. There was a slower decrease in volume in early expiration, with occasional early expiratory breath holding lasting up to three seconds, in the ketamine-induced children. The unique breathing pattern demonstrated with ketamine, consisting of large Vt, increased Ti/Te ratio, apneustic inspiratory pattern, and expiratory braking, contributed to an increased mean lung volume above functional residual capacity, of 2.40 ml.kg-1 body weight, in comparison to 1.27 ml.kg-1 in the children receiving halothane.