We examined the effect of isoflurane and sevoflurane on respiratory system resistance (Rmin,rs) in patients with chronic obstructive pulmonary disease (COPD). The diagnosis of COPD rests on the irreversibility of most of the airflow limitation and there usually is a small improvement after bronchodilator treatment. Ninety six consecutive patients undergoing thoracic surgery for peripheral lung cancer were enrolled. They were divided into two groups, based on a preoperative forced expiratory volume in 1s / forced vital capacity (FEV1/FVC) ratio, < or > 70%. Rmin,rs was measured after 5 and 10 min of maintenance anesthesia using the constant flow rapid occlusion method. Maintenance of anesthesia was randomized to thiopental 0.30 mg.Kg-1.min or 1.1 MAC end-tidal isoflurane or sevoflurane. Eleven patients were excluded; 2 because anesthesia was erroneously induced with propofol and 9 due to an incorrect tube position. Maintenance with thiopental failed to decrease Rmin,rs, whereas both volatile anesthetics were able to decrease Rmin,rs in patients with COPD. The percentage of patients who did not respond to volatile anesthetics was larger in those with COPD as well. In conclusion we have demonstrated that isoflurane and sevoflurane produce bronchodilation in patients with COPD.
The effect of volatile anesthetics on respiratory system resistance in patients with chronic obstructive pulmonary disease
VOLTA, Carlo Alberto;RAGAZZI, Riccardo;ALVISI, Raffaele
2005
Abstract
We examined the effect of isoflurane and sevoflurane on respiratory system resistance (Rmin,rs) in patients with chronic obstructive pulmonary disease (COPD). The diagnosis of COPD rests on the irreversibility of most of the airflow limitation and there usually is a small improvement after bronchodilator treatment. Ninety six consecutive patients undergoing thoracic surgery for peripheral lung cancer were enrolled. They were divided into two groups, based on a preoperative forced expiratory volume in 1s / forced vital capacity (FEV1/FVC) ratio, < or > 70%. Rmin,rs was measured after 5 and 10 min of maintenance anesthesia using the constant flow rapid occlusion method. Maintenance of anesthesia was randomized to thiopental 0.30 mg.Kg-1.min or 1.1 MAC end-tidal isoflurane or sevoflurane. Eleven patients were excluded; 2 because anesthesia was erroneously induced with propofol and 9 due to an incorrect tube position. Maintenance with thiopental failed to decrease Rmin,rs, whereas both volatile anesthetics were able to decrease Rmin,rs in patients with COPD. The percentage of patients who did not respond to volatile anesthetics was larger in those with COPD as well. In conclusion we have demonstrated that isoflurane and sevoflurane produce bronchodilation in patients with COPD.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
