The Effects Of Methytpredriisolone On Respiratory Mechanical Parameters In General Anaesthesia For Elderly Patients

ObjectiveTo observe the effect of methylprednisolone to the respiratorymechanical parameters change on elderly patients undergoing majorsurgeries with general anesthesia intubation after mechanical ventilation，and to further investigate whether methylprednisolone can improve therespiratory system degenerative diseases to the adverse effects in generalanesthesia.Materials and Methods60patients undergoing abdominal surgery from October2012toAugust2014were randomized in2groups. The patients, aged60-79years old, ASA grade Ⅰ～Ⅱ, weighed60~65kg, were divided intoexperimental group and control group,30patients each. The patients’ECG, SpO2, NBP were monitored intraoperatively. The patients wereinduced with midazolam0.05mg/kg, shun benzene sulfonic acidatracurium0.15mg/kg, fentanyl4mu g/kg, etomidate0.2mg/kg. Afterintubation, the tubes were connected to PB-7200for mechanicalventilation, taking capacity control (CMV) mode, with breath frequency12times/min, suction than1:2, volume tide10ml/kg, the Y type joint andconnection between the endotracheal tube Datex-Ohmeda monitorrespiratory mechanics transducer. Propofol and remifentanil were TCI tomaintain anesthesia. After endotracheal intubation, the experimentalgroup patients were given methylprednisolone1ml (40mg) intravenously,while control group patients1ml saline water. All the patients’ airwaypeak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl),airway resistance (Raw) were recorded before medication,10min,20 min,30min,40min after medication. The patients’ arterial blood gasanalysis before and20min after medication were also recorded,as wellas record of arterial blood oxygen partial pressure, arterial blood (PaO2)CO2partial pressure (PaCO2), breathe out at the end of the CO2partialpressure (PetCO2). All the data were analyzed by SPSS18.0softwarepackage for statistical analysis of experimental data, measurement datawith mean standard deviation (X±s) said, within the group to compareusing single factor analysis of variance; Line t test measurement data,categorical data using X2test, to P <0.05for the difference is statisticallysignificant.ResultsCompared with before the dosing, the control group to saline after10,20,30,40min when measuring the respiratory mechanics parametersof no statistically significant difference (P>0.05), the experimental groupafter the drug10,20,30,40min significantly higher, PaO2, Compl forPaCO2and PetCO2, Ppeak, Pplat, Raw were significantly decreased (P <0.05); Compared with control group, experimental group after the drug10,20,30,40min significantly higher, PaO2, Compl for PaCO2and PetCO2,Ppeak, Pplat, Raw were significantly decreased (P <0.05).ConclusionMethylprednisolone can significantly reduce carbon dioxide partialpressure in elderly patients, peak airway pressure, airway plateau pressureand airway resistance, increasing the oxygen partial pressure and lungcompliance, To substantiate methylprednisolone for elderly patients canimprove the respiratory system degenerative diseases to the adverseeffects of general anesthesia.