Pressure-support Ventilation in the Operating Room

We thank Dr. Feldman for his interesting remarks regarding our recent contribution to Anesthesiology, which showed that for the five tested anesthesia ventilators, pressure-support ventilation (PSV) functioned correctly.1Indeed, our laboratory study1showed that regarding trigger sensitivity and the system's ability to meet inspiratory flow during PSV, the most recent anesthesia ventilators have performances comparable to those of the modern intensive care unit ventilators. We agree with Dr. Feldman that PSV will facilitate the use of spontaneous breathing with both a laryngeal mask airway and an endotracheal tube. As stated in the discussion of our article1and in the accompanying editorial by Tantawy and Ehrenwerth,2the PSV mode may be used in the operating room in spontaneously breathing patients who are undergoing peripheral surgery more often during local–regional anesthesia combined with light sedation with a laryngeal mask airway3or an endotracheal tube. However, our study1only provides the information needed to use PSV in the operating room with confidence, and further clinical studies should now be conducted to better define the indications and settings of PSV during both local–regional and general anesthesia.*Hôpital Saint Eloi, Montpellier, France. s-jaber@chu-montpellier.fr