Statistical analysis was performed using the Bonferroni corrected t test. LF was determined by noting the difference between inspired and expired tidal volume. In addition, epigastric auscultation was performed to detect air entering the stomach. Spirometry was measured from the inspiratory and expiratory limb of the anesthesia circuit. Sp O2was measured using the finger pulse oximeter. The following data were recorded by an unblinded observer once every minute for the last 5 min for each ventilatory mode and the average reading used for analysis: end tidal carbon dioxide (ET CO 2), oxygen saturation (Sp O2), expired tidal volume (VTExp), leak fraction (LF), RR, noninvasive mean arterial pressure, and heart rate. No minimal respiratory rate (RR) or apnea backup was set on the ventilator. Each ventilatory mode was maintained for 10 min. Pressure support was initiated when inspiratory flow reached 3 l/min. PSV comprised positive end expiratory pressure (PEEP) set at 5 cm H 2O and pressure support set at 5 cm H 2O above PEEP. In group 2 (n = 20), patients underwent PSV, CPAP, and PSV in sequence. Initial pressure settings are usually around 10 cm H20 and then adjust based on patients comfort or clinical response. In group 1 (n = 20), patients underwent CPAP, PSV, and CPAP in sequence. Mechanical ventilation was begun (Evita 4 Draeger Medizintechnik GmbH, Luebeck, Germany) and the patients were allocated randomly to two crossover groups. The lungs were manually inflated until spontaneous breathing resumed. 8The volume of air in the cuff was adjusted so the airway sealing pressure was more than 15 cm H 2O. One experienced LMA user (> 1,000 uses) inserted or fixed the LMA (size 5, all patients) 7according to the manufacturer’s instructions (Laryngeal Mask Co., Henley-on-Thames, UK). ![]() h −1propofol in oxygen and air, with the inspired oxygen concentration adjusted to 30%.Patients were induced with 2 μg/kg fentanyl and 2.5 mg/kg propofol. A standard anesthesia protocol was followed and routine monitoring was applied. Ethics committee approval and written informed consent were obtained from the Leopold-Franzens University and patients, respectively. Forty consecutive adult patients (American Society of Anesthesiologists physical status I or II, aged 18–80 yr) undergoing peripheral musculoskeletal surgery in which the LMA was considered to be suitable were studied.
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