Effects of intravenous penehyclidine hydrochloride or doxofylline on respiratory mechanics during non-thoracotomy in patients with chronic obstructive pulmonary disease

Abstract

Objective To investigate the effects of intravenous penehyclidine hydrochloride or doxofylline on respiratory mechanics during non-thoracotomy in patients with chronic obstructive pulmonary disease (COPD).Methods One hundred and thirty-five ASA Ⅱ or Ⅲ patients with COPD, aged 55-86 yr, weighing 44-78 kg,scheduled for elective non-thoracotomy under general anesthesia, were randomly divided into 3 groups ( n = 45 each): control group (group C), penehyclidine hydrochloride group (group P) and doxofylline group (group D).Anesthesia was induced with fentanyl 4 μg/kg, propofol 1.5 rg/kg and cis-atracurium 0.2 mg/kg. The patients were tracheal intubated and mechanically ventilated. PETCO2 was maintained at 40 mm Hg. At 5 rin after tracheal intubation, penehyclidine hydrochloride 0.01 mg/kg was injected intravenously in group P, and doxofylline 4 mg/kg was injected intravenously in group D. The equal volume of normal saline was injected intravenously in group C. Anesthesia was maintained with propofol 5 mg· kg- 1 · h- 1, eis-atracurium 0.2 mg· kg- 1 · h- 1, and intermittent iv boluses of fentsnyl. The auditory evoked potential index was maintained at 15-20 during operation. The peak airway pressure, airway plateau pressure, lung compliance and airway resistance were recorded immediately before administration, and at 30, 45 and 60 rin after administration. Results Compared with group C, the peak airway pressure, airway plateau pressure and airway resistance were significantly decreased, while the lung compliance was significantly increased at each time point after administration in groups P and D ( P ＜ 0.05 ). There was no significant difference in the parameters of respiratory mechanics at each time point between group P and group D ( P ＞ 0.05). Conclusion Both intravenous penehyclidine hydrochloride and doxofylline can improve respiratory mechanics during non-thoracotomy in patients with COPD. Key words: Cholinergic antagonists; Bronchodilator agents; Respiratory mechanics; Pulmonary disease, chronic obstructive