British Journal of Anaesthesia, Vol 77, Issue 6 739-743, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
W. Habre, I. Matsumoto and P. D. Sly
Propofol may cause histamine release and alter airway tone and reactivity.
Although its use has been reported to be safe in asthmatics, there is a
lack of information on its effect on lung function in children with asthma.
We measured respiratory mechanics after i.v. or inhalation anaesthesia in
60 children, aged 2-12 yr, with or without asthma. Anaesthesia was induced
with propofol 3 mg kg-1, fentanyl 1 microgram kg-1 and atracurium 0.5 mg
kg-1 and maintained with an infusion of propofol 10 mg kg-1h-1 and 50%
nitrous oxide in oxygen. Halothane was administered subsequently at a
concentration of 1 MAC. Respiratory mechanics were measured by applying a
single- compartment model using multi-linear regression analysis to
calculate dynamic compliance (Crs,dyn) and respiratory system resistance
(Rrs), based on: Pao = V/Crs,dyn + V Rrs + PA,EE, where Pao = airway
opening pressure, PA,EE = alveolar pressure, V = volume and V = flow. The
two groups were comparable in age, weight and ventilation variables (tidal
volume and peak pressure). Respiratory mechanics during propofol
anaesthesia were comparable in normal and asthmatic children (Rrs = 20.5 X
10(-4) (SD 5.2 X 10(-4)) vs 21.5 X 10(-4) (5.7 X 10(-4)) kPa ml- 1 S-1 (ns)
and Crs,dyn = 247.5 (76.51 vs 235.1 (63.8) ml kPa-1 (ns)). Halothane
produced a minimal decrease in Rrs and a minimal increase in tidal volume
in both groups without changes in Crs,dyn. In conclusion, respiratory
mechanics were comparable after propofol anaesthesia in both children with
and without asthma. Changes in Rrs after halothane administration were not
clinically relevant.
CLINICAL INVESTIGATIONS
Propofol or halothane anaesthesia for children with asthma: effects on respiratory mechanics
Division of Clinical Sciences, Institute for Child Health Research and Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, Australia
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