Role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia / 中国基层医药

ABSTRACT

Objective To study the role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia.Methods A total of 60 COPD patients who received the upper abdominal surgery under general anesthesia were randomly assigned as regular treatment group (control,n=30) and aminophylline group (aminophylline,n=30).The aminophylline group was intravenously injected aminophylline (2mg/kg) after intubation,and the same volume of saline was injected for the control group.The respiratory mechanics,serum cytokines including tumor necrosis factor-α(TNF-α),interleukin-8 (IL-8) and interleukin-10(IL-10),recovery time and adverse cardiovascular events were measured.Results The general conditions,including gender,age,weight,smoking status,lung function,GOLD standard,surgical site,operation time and anesthetic time had no statistically significant differences between the two groups.During general anesthesia,aminophylline decreased the peak airway pressure(15 minutes,t=9.220,P=0.047),the plate airway pressure(15 minutes,t=5.906,P=0.025) and the airway resistance(15 minutes,t=10.438,P=0.04).Aminophylline increased the respiratory compliance(15 minutes,t=-7.431,P=0.001).Aminophylline attenuated the increase of inflammatory cytokines,such as TNF-α(8 hours,t=6.374,P=0.000),IL-8(8 hours,t=7.716,P=0.000) and hsCRP(8 hours,t=6.665,P=0.000).Aminophylline shortened the time to spontaneous ventilation(t=3.439,P=0.001),opening eyes(t=3.516,P=0.001),limb movement(t=6.249,P=0.000) and extubation (t=3.159,P=0.003).Administration of aminophylline had no obvious adverse effects on blood pressure and heart rate.Conclusion Administration of aminophylline for COPD patients undergoing abdominal surgery under general anesthesia can improve respiratory mechanics,downregulate inflammatory cytokines,accelerate recovery after general anesthesia and possess no obvious adverse cardiovascular effects,which is worthy of popularization.