Lee Do-Won, Kim Eun-Soo, Do Wang-Seok, Lee Han-Bit, Kim Eun-Jung, Kim Cheul-Hong
Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Republic of Korea.
J Dent Anesth Pain Med. 2017 Dec;17(4):265-270. doi: 10.17245/jdapm.2017.17.4.265. Epub 2017 Dec 28.
Endotracheal intubation during anesthesia induction may increase airway resistance (R) and decrease dynamic lung compliance (C). We hypothesized that prophylactic treatment with a transdermal β2-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube.
Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each). The night before surgery, a 2-mg TP was applied to patients in the TP group. Standard monitors were recorded, and target controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. Simultaneously, end-tidal carbon dioxide, R, and C were determined at 5, 10, and 15 min intervals after endotracheal intubation.
There was no significant difference in demographic data between the two groups. The TP group was associated with a lower R and a higher C, as compared to the control group. R was significantly lower at 10 min (P < 0.05) and 15 min (P < 0.01), and C was significantly higher at 5 min (P < 0.05) and 15 min (P < 0.01) in the TP group. A trend towards a lower R was observed showing a statistically significant difference 5 min after endotracheal intubation (P < 0.01) in each group.
Prophylactic treatment with TP showed a bronchodilatory effect through suppressing an increase in R and a decrease in C after anesthesia induction without severe adverse effects.
麻醉诱导期间气管插管可能会增加气道阻力（R）并降低动态肺顺应性（C）。我们假设经皮β2受体激动剂妥洛特罗贴剂（TP）进行预防性治疗有助于降低气管插管后支气管痉挛的风险。
82例表现为阻塞性模式的美国麻醉医师协会（ASA）I或II级成年患者被随机分为对照组和TP组（每组n = 41）。手术前一晚，给TP组患者贴上2mg的TP。记录标准监测指标，并使用丙泊酚和瑞芬太尼靶控输注（TCI）进行麻醉诱导和维持。同时，在气管插管后每隔5、10和15分钟测定呼气末二氧化碳、R和C。
两组患者的人口统计学数据无显著差异。与对照组相比，TP组的R较低，C较高。TP组在10分钟时R显著降低（P < 0.05），在15分钟时显著降低（P < 0.01），在5分钟时C显著升高（P < 0.05），在15分钟时显著升高（P < 0.01）。每组气管插管后5分钟观察到R有降低趋势，差异有统计学意义（P < 0.01）。
TP预防性治疗通过抑制麻醉诱导后R升高和C降低显示出支气管舒张作用，且无严重不良反应。
