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Anesth Analg 2005;100:348-353
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000140240.83236.AC

CARDIOVASCULAR ANESTHESIA

The Effect of Volatile Anesthetics on Respiratory System Resistance in Patients with Chronic Obstructive Pulmonary Disease

C. A. Volta, MD, V. Alvisi, MD, S. Petrini, MD, S. Zardi, MD, E. Marangoni, MD, R. Ragazzi, MD, M. Capuzzo, MD, and R. Alvisi, MD

Department of Surgical, Anesthesiological and Radiological Science, Section of Anesthesia and Intensive Care, S. Anna Hospital, University of Ferrara, Ferrara, Italy

Address correspondence and reprint requests to Carlo Alberto Volta, MD, Department of Surgical, Anesthesiological and Radiological Science, Section of Anesthesia and Intensive Care, S. Anna Hospital, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. Address e-mail to vlc{at}dns.unife.it.

We examined the effect of isoflurane and sevoflurane on respiratory system resistance (Rmin,rs) in patients with chronic obstructive pulmonary disease (COPD). The diagnosis of COPD rests on the presence of airway obstruction, which is only partially reversible after bronchodilator treatment. Ninety-six consecutive patients undergoing thoracic surgery for peripheral lung cancer were enrolled. They were divided into two groups: preoperative forced expiratory volume in 1 s/forced vital capacity ratio <70% or >70%. Rmin,rs was measured after 5 and 10 min of maintenance anesthesia by using the constant flow/rapid occlusion method. Maintenance of anesthesia was randomized to thiopental 0.30 mg · kg–1 · min–1 or 1.1 minimum alveolar anesthetic concentration end-tidal isoflurane or sevoflurane. Eleven patients were excluded: two because anesthesia was erroneously induced with propofol and nine because of an incorrect tube position. Maintenance with thiopental failed to decrease Rmin,rs, whereas both volatile anesthetics were able to decrease Rmin,rs in patients with COPD. The percentage of patients who did not respond to volatile anesthetics was larger in those with COPD as well. In conclusion, we have demonstrated that isoflurane and sevoflurane produce bronchodilation in patients with COPD.




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J.-I. Satoh, M. Yamakage, T. Kobayashi, N. Tohse, H. Watanabe, and A. Namiki
Desflurane but not sevoflurane can increase lung resistance via tachykinin pathways
Br. J. Anaesth., May 1, 2009; 102(5): 704 - 713.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.