Source:http://linkedlifedata.com/resource/pubmed/id/11273942
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
4
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| pubmed:dateCreated |
2001-3-29
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| pubmed:abstractText |
Optimal analgesia is important after thoracotomy in pulmonary-limited patients to avoid pain-related pulmonary complications. Thoracic epidural anesthesia (TEA) can provide excellent pain relief. However, potential paralysis of respiratory muscles and changes in bronchial tone might be unfavorable in patients with end-stage chronic obstructive pulmonary disease (COPD). Therefore, we evaluated the effect of TEA on maximal inspiratory pressure, pattern of breathing, ventilatory mechanics, and gas exchange in 12 end-stage COPD patients. Pulmonary resistance, work of breathing, dynamic intrinsic positive end-expiratory pressure, and peak inspiratory and expiratory flow rates were evaluated by assessing esophageal pressure and airflow. An increase in minute ventilation (7.50 +/- 2.60 vs 8.70 +/- 2.10 L/min; P = 0.04) by means of increased tidal volume (0.46 +/- 0.16 vs 0.53 +/- 0.14 L/breath; P = 0.003) was detected after TEA. These changes were accompanied by an increase in peak inspiratory flow rate (0.48 +/- 0.17 vs 0.55 +/- 0.14 L/s; P = 0.02) and a decrease in pulmonary resistance (20.7 +/- 9.9 vs 16.6 +/- 8.1 cm H(2)O. L(-1). s(-1); P = 0.02). Peak expiratory flow rate, dynamic intrinsic positive end-expiratory pressure, work of breathing, PaO(2), and maximal inspiratory pressure were unchanged (all P > 0.50). We conclude that TEA with bupivacaine 0.25% can be used safely in end-stage COPD patients. IMPLICATIONS: Thoracic epidural anesthesia with bupivacaine 0.25% does not impair ventilatory mechanics and inspiratory respiratory muscle strength in severely limited chronic obstructive pulmonary disease patients. Thus, thoracic epidural anesthesia can be used safely in patients with end-stage chronic obstructive pulmonary disease.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
AIM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Apr
|
| pubmed:issn |
0003-2999
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
92
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
1015-9
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:11273942-Adult,
pubmed-meshheading:11273942-Aged,
pubmed-meshheading:11273942-Airway Resistance,
pubmed-meshheading:11273942-Analgesia, Epidural,
pubmed-meshheading:11273942-Anesthetics, Local,
pubmed-meshheading:11273942-Bupivacaine,
pubmed-meshheading:11273942-Electrocardiography,
pubmed-meshheading:11273942-Female,
pubmed-meshheading:11273942-Humans,
pubmed-meshheading:11273942-Inspiratory Capacity,
pubmed-meshheading:11273942-Lung Diseases, Obstructive,
pubmed-meshheading:11273942-Male,
pubmed-meshheading:11273942-Middle Aged,
pubmed-meshheading:11273942-Positive-Pressure Respiration,
pubmed-meshheading:11273942-Pulmonary Gas Exchange,
pubmed-meshheading:11273942-Respiratory Function Tests,
pubmed-meshheading:11273942-Respiratory Mechanics,
pubmed-meshheading:11273942-Respiratory Muscles,
pubmed-meshheading:11273942-Vital Capacity,
pubmed-meshheading:11273942-Work of Breathing
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| pubmed:year |
2001
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| pubmed:articleTitle |
The effects of thoracic epidural analgesia with bupivacaine 0.25% on ventilatory mechanics in patients with severe chronic obstructive pulmonary disease.
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| pubmed:affiliation |
Department of Cardiothoracic and Vascular Anesthesia & Intensive Care Medicine, University of Vienna, Austria.
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| pubmed:publicationType |
Journal Article,
Clinical Trial
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