Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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The effect of tulobuterol patches on the respiratory system after endotracheal intubation

  • Lee, Do-Won (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Eun-Soo (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Do, Wang-Seok (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Lee, Han-Bit (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Eun-Jung (Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Kim, Cheul-Hong (Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute)
  • Received : 2017.11.12
  • Accepted : 2017.12.03
  • Published : 2017.12.31
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Abstract

Background: Endotracheal intubation during anesthesia induction may increase airway resistance ($R_{aw}$) and decrease dynamic lung compliance ($C_{dyn}$). We hypothesized that prophylactic treatment with a transdermal ${\beta}2$-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube. Methods: Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each). The night before surgery, a 2-mg TP was applied to patients in the TP group. Standard monitors were recorded, and target controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. Simultaneously, end-tidal carbon dioxide, $R_{aw}$, and $C_{dyn}$ were determined at 5, 10, and 15 min intervals after endotracheal intubation. Results: There was no significant difference in demographic data between the two groups. The TP group was associated with a lower $R_{aw}$ and a higher $C_{dyn}$, as compared to the control group. $R_{aw}$ was significantly lower at 10 min (P < 0.05) and 15 min (P < 0.01), and $C_{dyn}$ was significantly higher at 5 min (P < 0.05) and 15 min (P < 0.01) in the TP group. A trend towards a lower $R_{aw}$ was observed showing a statistically significant difference 5 min after endotracheal intubation (P < 0.01) in each group. Conclusions: Prophylactic treatment with TP showed a bronchodilatory effect through suppressing an increase in $R_{aw}$ and a decrease in $C_{dyn}$ after anesthesia induction without severe adverse effects.

Keywords

References

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