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Phrenic nerve stimulation during halothane anesthesia. Effects of atelectasis

G Hedenstierna¹, L Tokics, H Lundquist

¹Department of Anesthesia, Huddinge University Hospital, Sweden.

|April 1, 1994

Summary

Phrenic nerve stimulation (PNS) can reduce atelectasis during anesthesia by contracting the diaphragm. This method shows promise in preventing lung collapse in anesthetized patients.

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Area of Science:

Anesthesiology
Respiratory Physiology
Thoracic Surgery

Background:

Anesthesia can lead to atelectasis due to reduced respiratory muscle tone, particularly the diaphragm.
Phrenic nerve stimulation (PNS) was investigated as a method to contract the diaphragm and mitigate atelectasis.

Purpose of the Study:

To determine if diaphragm contraction via PNS can reduce or prevent atelectasis during anesthesia.

Main Methods:

Twelve patients undergoing halothane anesthesia were studied.
Phrenic nerve stimulation (PNS) was applied using an external electrode.
Computed tomography (CT) was used to measure chest dimensions and the area of atelectasis.

Main Results:

Right-sided PNS reduced atelectasis from 5.1 to 3.8 cm2.

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Positive end-expiratory pressure (PEEP) with large tidal volumes initially reduced atelectasis to 1.1 cm2, but it increased upon discontinuation.

PNS immediately after PEEP prevented atelectasis increase, maintaining it at 0.9 cm2.

Conclusions:

Diaphragm contraction induced by PNS effectively reduces atelectasis in anesthetized individuals.
PNS can be a valuable tool in managing or preventing lung atelectasis during anesthesia.