Faculty Collaboration Database

Absence of bronchodilation during desflurane anesthesia: a comparison to sevoflurane and thiopental. Anesthesiology 2000 Aug;93(2):404-8

Date

07/26/2000

Pubmed ID

10910489

DOI

10.1097/00000542-200008000-00018

Scopus ID

2-s2.0-0033860168 (requires institutional sign-in at Scopus site)   125 Citations

Abstract

BACKGROUND: Bronchospasm is a potential complication in anyone undergoing general anesthesia. Because volatile anesthetics relax bronchial smooth muscle, the effects of two newer volatile anesthetics, desflurane and sevoflurane, on respiratory resistance were evaluated. The authors hypothesized that desflurane would have greater bronchodilating effects because of its ability to increase sympathetic nervous system activity.

METHODS: Informed consent was obtained from patients undergoing elective surgery with general anesthesia. We recorded airway flow and pressure after thiopental induction and tracheal intubation (baseline) and for 10 min after beginning volatile anesthesia ( approximately 1 minimum alveolar concentration inspired). Respiratory system resistance was determined using the isovolume technique.

RESULTS: Fifty subjects were randomized to receive sevoflurane (n = 20), desflurane (n = 20), or thiopental infusion (n = 10, 0.25 mg. kg-1. h-1). There were no differences between groups for age, height, weight, smoking history, and American Society of Anesthesiologists physical class. On average, sevoflurane reduced respiratory resistance 15% below baseline, whereas both desflurane (+5%) and thiopental (+10%) did not decrease respiratory resistance. The respiratory resistance changes did not differ in patients with and without a history of smoking during sevoflurane or thiopental. In contrast, administration of desflurane to smokers resulted in the greatest increase in respiratory resistance.

CONCLUSIONS: Sevoflurane causes moderate bronchodilation that is not observed with desflurane or sodium thiopental. The bronchoconstriction produced by desflurane was primarily noted in patients who currently smoked. (Key words: Bronchospasm; respiratory resistance; volatile anesthetics.)

Author List

Goff MJ, Arain SR, Ficke DJ, Uhrich TD, Ebert TJ

Author

Thomas J. Ebert MD, PhD Adjunct Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anesthesia, General
Anesthetics, Inhalation
Anesthetics, Intravenous
Bronchoconstriction
Female
Hemodynamics
Humans
Intubation, Intratracheal
Isoflurane
Male
Methyl Ethers
Middle Aged
Smoking
Thiopental