en
Scientific article
English

Salbutamol prevents the increase of respiratory resistance caused by tracheal intubation during sevoflurane anesthesia in asthmatic children

Published inAnesthesia and analgesia, vol. 93, no. 4, p. 898-902
Publication date2001
Abstract

Asthmatic children having their tracheas intubated with sevoflurane often have an increase in respiratory system resistance (Rrs). In this randomized, placebo-controlled, double-blinded study, we investigated the protective effect of an inhaled beta2-adrenergic agonist. Either salbutamol or placebo was administered 30 to 60 min before anesthesia to 30 mildly to moderately asthmatic children scheduled for elective surgery. Induction was performed with sevoflurane in a mixture of 50% nitrous oxide in oxygen and maintained at 3%, with children breathing spontaneously via a face mask and Jackson-Rees modification of the T-piece. Airway opening pressure and flow were measured before and after insertion of an oral endotracheal tube. Rrs and respiratory system compliance were calculated with multilinear regression analysis. The groups were comparable with respect to age, weight, asthma history, and breathing pattern. Intubation induced a different Rrs response in the two groups: children treated with salbutamol showed a 6.0% (-25.2% to +13.2%) decrease (mean, 95% confidence interval), whereas in the Placebo group there was a 17.7% (+4.4% to +30.9%) increase (P = 0.04). Neither asthma history nor the serum inflammation marker eosinophilic cationic protein was predictive for this response. We conclude that when using sevoflurane in mildly to moderately asthmatic children, a preanesthetic treatment with inhaled salbutamol is protective of an increase in Rrs.

Keywords
  • Adolescent
  • Airway Resistance/drug effects
  • Albuterol/therapeutic use
  • Algorithms
  • Anesthesia, Inhalation
  • Anesthetics, Inhalation
  • Asthma/drug therapy/physiopathology
  • Biological Markers
  • Blood Proteins/metabolism
  • Bronchodilator Agents/therapeutic use
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Eosinophil Granule Proteins
  • Female
  • Humans
  • Intubation, Intratracheal
  • Male
  • Methyl Ethers
  • Preanesthetic Medication
  • Respiratory Mechanics/drug effects
  • Ribonucleases
  • Risk Factors
Citation (ISO format)
SCALFARO, P et al. Salbutamol prevents the increase of respiratory resistance caused by tracheal intubation during sevoflurane anesthesia in asthmatic children. In: Anesthesia and analgesia, 2001, vol. 93, n° 4, p. 898–902. doi: 10.1097/00000539-200110000-00019
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal0003-2999
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