The effect of tulobuterol patches on the respiratory system after endotracheal intubation.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.