Wu R S, Wu K C, Wong T K, Tsai Y H, Cheng R K, Bishop M J, Tan P P
China Medical College Hospital, Taichung, Taiwan, Republic of China.
Br J Anaesth. 2000 Mar;84(3):358-62. doi: 10.1093/oxfordjournals.bja.a013440.
We have studied the effects of a beta-agonist, fenoterol, and a cholinergic antagonist, ipratropium, on post-intubation total respiratory system resistance (Rrs) in asthmatics who developed increased Rrs after tracheal intubation. Sixteen stable asthmatics in whom Rrs increased after intubation were allocated randomly to receive either 10 puffs of fenoterol (group F) or 10 puffs of ipratropium (group IB) via a metered dose inhaler 5 min after intubation. Anaesthesia was induced and maintained with propofol i.v. Rrs was recorded before treatment and again 5, 15 and 30 min after treatment. Rrs decreased significantly from pretreatment values by mean 53 (SD 8)%, 53 (7)% and 58 (6)% at 5, 15 and 30 min, respectively, in group F, but declined by only 12 (6)%, 15 (4)% and 17 (5)% in group IB. At all times after treatment, patients in the fenoterol group had significantly lower Rrs values than those in the ipratropium group. We conclude that increased Rrs after tracheal intubation in asthmatics can be reduced effectively by treatment with fenoterol. A secondary finding of our study was that even after induction of anaesthesia with propofol, patients with a history of asthma may develop high Rrs.
我们研究了β受体激动剂非诺特罗和胆碱能拮抗剂异丙托溴铵对气管插管后出现总呼吸系统阻力（Rrs）增加的哮喘患者插管后Rrs的影响。16名插管后Rrs增加的稳定哮喘患者被随机分配，在插管后5分钟通过定量吸入器接受10喷非诺特罗（F组）或10喷异丙托溴铵（IB组）。采用丙泊酚静脉诱导和维持麻醉。在治疗前以及治疗后5、15和30分钟记录Rrs。F组在治疗后5、15和30分钟时，Rrs分别较治疗前值显著降低，平均降低53（标准差8）%、53（7）%和58（6）%，而IB组仅降低12（6）%、15（4）%和17（5）%。在治疗后的所有时间点，非诺特罗组患者的Rrs值均显著低于异丙托溴铵组。我们得出结论，哮喘患者气管插管后增加的Rrs可通过非诺特罗治疗有效降低。我们研究的一个次要发现是，即使在用丙泊酚诱导麻醉后，有哮喘病史的患者仍可能出现高Rrs。
