Abstract
Purpose
Several experimental and clinical studies have demonstrated a direct bronchoconstrictor effect of opioids on smooth bronchial musculature followingiv administration. The aim of this study was to evaluate the effects of alfentanil on respiratory system mechanics in a group of ASA I patients ventilated mechanically during general anesthesia.
Clinical features
Twenty consecutive ASA I patients (ten men and ten women) scheduled for general surgery interventions were studied (mean age 45.4 ± 9.9 yr, mean weight 61.9 ± 6.7 kg). Exclusion criteria were a history of chronic obstructive pulmonary disease, asthma or other pulmonary disease, atopy, wheezes, smoking and age below 18 yr. Subjects were randomly divided in two groups: Group A, receiving alfentanil at a 15 μg·kg−1 dose and Group B receiving alfentanil at a 30 μg·kg−1 dose. Respiratory mechanic variables were acquired at baseline (T0) and after three, ten and 15 min (T1, T2 and T3, respectively). We compared the basal values to the values measured at each time interval; basal values, prior to drug administration, served as control for each patient. P values < 0.05 were considered statistically significant.
Results
We did not observe significant differences in respiratory mechanic variables after the administration of alfentanil, 15 and 30 μg·kg−1. More specifically, respiratory system compliance and the different subcomponents of respiratory system resistances (i.e., maximum, minimum and delta resistance of respiratory system) were within normal limits and did not vary after alfentanil administration.
Conclusion
No respiratory adverse effect was reported after alfentaniliv administration.
Résumé
Objectif
De nombreuses études expérimentales et cliniques ont démontré un effet bronchoconstricteur direct des opioïdes intraveineux sur la musculature lisse bronchique. Le but de notre étude était d’évaluer les effets de l’alfentanil sur la mécanique du système respiratoire chez un groupe de patients ASA I ventilés mécaniquement pendant une anesthésie générale.
Éléments cliniques
Vingt patients consécutifs ASA I ont été étudiés (dix hommes) pendant une intervention de chirurgie générale (âge moyen 45,4 ± 9,9 ans, poids moyen 61,9 ± 6,7 kg). Les critères d’exclusion étaient: un historique de bronchite chronique obstructive, asthme ou autres maladies pulmonaires, allergies, tabagisme, sibilances à l’auscultation pulmonaire et un âge inférieur à 18 ans. Les sujets ont été randomisés en deux groupes: Groupe A, recevant 15 μg·kg− 1 d’alfentanil et Groupe B recevant 30 μg·kg− 1 d’alfentanil. Les variables de la mécanique respiratoire ont été mesurés au départ (T0) et après trois, dix et 15 min (T1, T2 et T3, respectivement. Les données de base ont été comparées avec les données mesurées après chaque intervalle de temps, les valeurs de P < 0,05 ont été jugées statistiquement significatives.
Résultats
Aucune différence significative entre les variables de mécanique respiratoire n’a été observée après l’administration d’alfentanil, aussi bien après une dose de 15 que de 30 μg·kg− 1. En particulier, la compliance du système respiratoire et les différentes variables des composantes des résistances du système respiratoire (les résistances maximale, minimale et delta du système respiratoire) se situaient dans des limites normales et n’ont pas montré de variations significatives après alfentanil.
Conclusion
Aucun effet secondaire sur la mécanique respiratoire n’a été remarqué après l’administration iv d’alfentanil.
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Conti, G., De Cosmo, G., Bocci, M.G. et al. Alfentanil does not increase resistance of the respiratory system in ASA I patients ventilated mechanically during general anesthesia. Can J Anesth 49, 718–723 (2002). https://doi.org/10.1007/BF03017452
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DOI: https://doi.org/10.1007/BF03017452