Abstract
Objective To investigate the effects of sevoflurane and isoflurane inhalation on airwayresistance, pulmonary compliance, and airway peak pressure in smoking versus nonsmoking patients early after tracheal intubation in general anaesthesia. Methods Eighty patients, with (n=40) or without (n=40)smoking history (ASA Ⅰ～Ⅱ ), scheduled for surgery under general anesthesia were randomly divided into four groups (n=20 each). Patients with smoking history were randomly divided into sevoflurane group (SS)and isoflurane group (SI), and those without smoking history into sevoflurane group (NS) and isoflurane group (NI). Datex-Ultima anaesthetic agent monitor was used to monitor lung compliance and airway peak pressure of patients at 4, 8, 12, 16 mins after minimal alveolar concentration (1 MAC) of inhalation anesthetics was reached. Meanwhile, non-invasive hemodynamic monitoring was used to monitor airway resistance, recorded and compared the changes in each of these indicators in the 4 groups after anesthetics inhalation. Results After tracheal intubation in general anesthesia and maintenance on inhaled sevoflurane and isoflurane for 4, 8, 12 and 16 mins, all the patients showed a significant decline in airway resistance and airway peak pressure (all P＜0.05) compared with before inhalation. Of all the groups, the declines tended to become stable after 8 mins in groups SS and NS [airway resistance: (10.38±1.12) cm H2O·L-1·s-1 in SS group and (9.65±1.04) cm H2O·L-1·s-1 in NS group; airway peak pressure: (13.52±1.01) cm H2O in SS group and (12.86±0.94) cm H2O in NS group; 1 cm H2O=0.098 kPa], and after 12 mins in the groups SI NI group; airway peak pressure:(13.47±0.88) cm H2O in SI group and (12.85±0.65) cm H2O in NI group].Moreover, the declines were much greater in nonsmokers than those in smokers (all P＜0.05). The pulmonary compliance showed no significant change compared with before inhalation after the maintenance inhalation of sevoflurane and isoflurane among the 4 groups (all P＞0.05), nor any difference between non-smoking and smoking group at given time spots (all P＞0.05). Conclusion Sevoflurane and isoflurane exposure significantly decrease the airway resistance and airway peak pressure in all the patients after tracheal intubation under general anesthesia. The decline is much greater in nonsmokers as compared to smokers. Key words: Anesthesia,general; Isoflurane; Sevoflurane; Smoking; Respiratory mechanics
Published Version
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