Background and Goal of Study: It is known that cigarette smokers have a greater risk of respiratory complications during anaesthesia compared with non smokers. It is known also that aminophylline in doses of 2-5 mg/kg shortens the recovery from anaesthesia and improves bispectral index scores. The purpose of our study is the evaluation of the hypothesis that administration of aminophylline at the end of anaesthesia with desflurane can influence the recovery time and it can reduce respiratory complications in smokers.
Materials and Methods: 56 smokers, ASA I or II, undergoing ambulatory urological procedures with the use of cLMA and spontaneous breathing were randomly allocated into 2 groups: DES and DES-A. The anaesthetic agent used was desflurane in a mixture of oxygen and nitrous oxide (1:1) with fresh gas flow at 3 l/min and etMAC 1,0. The induction and the maintenance of anaesthesia was standardize in all cases. Standard monitoring (SpO2, etCO2, NIBP, ECG) was used in all patients. In DES-A group at the end of desflurane administration, aminophylline at a dose of 3 mg/kg was given. During recovery the following factors were assessed: 1) time of eye opening, 2) time to verbal command, 3) time of removal of the cLMA and 4) postoperative recovery score (Aldrete score >8).
Respiratory complication such as the incidents of cough, laryngospasm, bronchospasm and desaturation were also recorded. Results and Discussion: Spontaneous breathing after induction in anaesthesia was accomplished at 5,95 ± 1,6 min. The times of eye opening, verbal command and removal of cLMA in DES group were 7,15 ± 1,6 min, 7,8 ± 2,2 min, 8,5 ± 2,5 min and in DES-A group were 6,8 ± 1,4 min (p = 0,29), 7,3 ± 1,9 min (p = 0, 35), 8,2 ± 2,1 min (p = 0, 61) respectively.
The time of achieving Aldrete score > 8 was in DES group at 10 ± 2,3 min and in DES-A group at 9,7 ± 2,1 min (p = 0,59).
There were not important differences in the complication from the respiratory system in both groups. The DES-A group in comparison with the DES group appeared to have elevated heart rate during recovery.
Conclusion(s): The administration of aminophylline in smokers after desflurane anaesthesia is related with shorter recovery times without statistically significant differences but does not reduce the respiratory complications.
Eshima R et al. Airway Responses During Desflurane Versus Sevoflurane Administration via a Laryngeal Mask Airway in Smokers. Anesth Analg 2006;103:1147-54