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*Department of Anesthesia, Chiba Hokusoh Hospital, Chiba, Japan;
Department of Anesthesia, Tama-Nagayama Hospital;
Department of Anesthesiology, Nippon Medical School;
Department of Anesthesiology, Tokyo Jikeikai Medical School, Tokyo, Japan; and
||Center for Anesthesiology Research, The Cleveland Clinic Foundation, Ohio
Address correspondence and reprint requests to Zen’ichiro Wajima, MD, PhD, Department of Anesthesia, Chiba Hokusoh Hospital, Nippon Medical School, 1715, Kamagari, Inba-mura, Inba-gun, Chiba 270–1694, Japan. Address e-mail to HFB01245{at}nifty.com
Prostaglandin (PG) E1 relaxes airway smooth muscle in animals. However, no clinical data have been published on the bronchorelaxant effects of IV alprostadil, an analog of PGE1. We have described experimental thiamylal-fentanyl-induced bronchoconstriction in humans; we now report the effect of IV alprostadil on thiamylal-fentanyl-induced bronchoconstriction. Thirty-two patients were allocated randomly to a control group (n = 16) and alprostadil group (n = 16). Anesthesia was induced with thiamylal 5 mg/kg and vecuronium 0.3 mg/kg and maintained with a continuous infusion of thiamylal 15 mg · kg-1 · h-1. The lungs of the patients were ventilated with 50% nitrous oxide in oxygen. Twenty minutes after the induction of anesthesia, patients in the control group were given a continuous infusion of normal saline 20 mL/h, and those in the alprostadil group received a continuous infusion of alprostadil 0.2 µg · kg-1 · min-1 (20 mL/h), both for 60 min. Both groups were then given fentanyl 5 µg/kg. Systolic and diastolic arterial blood pressure, heart rate, mean airway resistance (Rawm), expiratory airway resistance (Rawe), and dynamic lung compliance (Cdyn) were measured at the baseline, just before the fentanyl injection (T30), at three consecutive 6-min intervals after fentanyl injection (T36, T42, and T48), and 30 min after fentanyl injection (T60). Baseline Rawm, Rawe, and Cdyn values were comparable between groups. In the control group, both Rawm and Rawe were significantly increased at T36–60, and Cdyn was significantly decreased at T36–60 compared with the baseline. Patients given alprostadil showed no change in Rawm, Rawe, or Cdyn at T36–60. Thus, IV alprostadil seems to have a bronchodilator effect in humans.
IMPLICATIONS:IV alprostadil, an analog of prostaglandin E1, prevents thiamylal-fentanyl-induced bronchoconstriction in humans. This finding suggests that IV alprostadil has a bronchodilator effect.
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  Z. Wajima, T. Shiga, K. Imanaga, T. Inoue, and R. Ogawa Effect of prophylactic bronchodilator treatment with i.v. carperitide on airway resistance and lung compliance after tracheal intubation Br. J. Anaesth., May 1, 2006; 96(5): 660 - 664. [Abstract] [Full Text] [PDF]
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