Effect Of Bronchodilator Treatment On Respiratory Mechanics To Patients With Chronic Obstructive Pulmonary Disease

Objective:To test the effect of bronchodilator treatment before surgery on respiratory mechanics after trancheal intubation to patients with chronic obstructive pulmonary disease. Methods: 96 patients with chronic obstructive pulmonary disease were randomized to receive one of three inhaled medications 1h before surgery. Group â…  (albuterol group, n = 32)patients inhaled four puffs of albuterol(400 u g); group â…¡ (ipratropium bromide group, n=30) patients inhaled four puffs of ipratropium(80 u g) ; group â…¢(placebo group; n=34)no medicine was used. After tracheal intubation,auscultation of chest was performed in all patients to determine if bronchospasm was present. Lung-chest wall compliance and airway pressure and resistance were measured in 2,5,and 15 min after tracheal intubation. Results:Four patients(two smokers,one nonsmoker) with chronic obstructive pulmonary disease in group â…¢ developed audible wheezing whereas no patients developed bronchospasm in either group â…  or group â…¡.Patients in both bronchodilator groups had significantly both lower lung pressure and lower lung resistence and higher lung-chest wall compliance.The effect was more pronounced in patients with chronic obstructive pulmonary disease than patients without it . There was no change in respiratory mechanics after the use of isoflurane. Conclusions: 1. Bronchodilator treatment before surgery can decrease the probability of bronchospasm happening after trancheal intubation. Prophylactic treatment with bronchodilator produced higher lung-chest wall compliance and lower airway pressure and resistance than no use in patients either with or without chronic obstructive pulmonary disease. 2. Prophylactic treatment with bronchodilator before surgery can produce protective effection on airway to patients with chronic...