2006 Fiscal Year Final Research Report Summary
What kind of anesthesia method is best for smokers or COPD patient?
| Project/Area Number |
16591569
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Section | 一般 |
|---|
| Research Field |
Anesthesiology/Resuscitation studies
|
|---|
| Research Institution | Nippon Medical School |
|---|
Principal Investigator |
WAJIMA Zen'ichiro Nippon Medical School, Faculty of Medicine, Assistant Professor, 医学部, 講師 (50291729)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
INOUE Tetsuo Nippon Medical School, Faculty of Medicine, Professor, 医学部, 教授 (00103953)
|
|---|
| Project Period (FY) |
2004 – 2006
|
| Keywords | lung resistance / lung compliance / carperitide / smoker / nonsmoker / bronchodilator / perioperative period |
|---|
| Research Abstract |
Background. Lung resistance increases after induction of anaesthesia. We hypothesized that prophylactic bronchodilation with intravenous carperitide before tracheal intubation would decrease airway resistance and increase lung compliance after placement of the endotracheal tube in both smokers and nonsmokers.
Methods. Ninety-seven adults aged 24 to 59 years were randomized to receive normal saline (0.9% saline) (control) or carperitide, 0.2 μg kg^<-1>, min^<-1>, intravenously throughout the study. The 97 patients included smokers and nonsmokers; thus, the study was conducted in four groups of patients : smokers who received saline (n=21), nonsmokers who received saline (n=27), smokers who received carperitide (n=19), and nonsmokers who received carperitide (n=30). Thirty minutes after starting saline or carperitide infusion, we administered thiamylal 5 mg kg^<-1> and fentanyl 5μg kg^<-1>, to induce general anaesthesia and vecuronium 0.3 mg kg^<-1> for muscle relaxation. Continuous infus
… More
ion of thiamylal 15-mg kg^<-1> hr^<-1> followed anesthetic induction. Mean airway resistance (Rawm), expiratory airway resistance (Rawe) and dynamic lung compliance (Cdyn) were determined 4, 8, 12 and 16 minutes after tracheal intubation and compared between the four groups.
Results. At 4 minutes after intubation, Rawm and Rawe values were higher and Cdyn value was lower in smokers than in nonsmokers in the control group. Rawm and Rawe values were lower and Cdyn value was higher in smokers in the carperitide group than in smokers in the control group. Rawm and Rawe were lower in nonsmokers in the carperitide group than in nonsmokers in the control group.
Conclusions. Marked bronchoconstriction occurred especially in the control groups (smokers and nonsmokers) 4 minutes after intubation. Our results suggest that prophylactic treatment with carperitide before anaesthesia induction and endotracheal intubation is advantageous for middle-aged smokers without chronic obstructive pulmonary disease, and that it may also be beneficial even for nonsmokers. Less
|
