Ventilatory responses to inspiratory resistive loading before and after gastrectomy during isoflurane anesthesia. 1995

T Kochi, and T Nishino
Department of Anesthesia, National Cancer Center Hospital East, Chiba, Japan.

We tested the hypothesis that steady-state responses to inspiratory-flow-resistive loading would be preserved immediately after upper abdominal surgery in anesthetized patients. Twenty patients were studied immediately before and after gastrectomy under 1 minimum alveolar anesthetic concentration (MAC) of isoflurane anesthesia. Ventilation, airway occlusion pressure, and Paco2 were measured before and during inspiratory-flow-resistive breathing lasting from 6 to 7 min. Ten of 20 subjects were tested with resistance of 51.8 cm H2O.L-1.s-1 (Load 1) and the remaining 10 subjects were tested with resistance of 83.3 cm H2O.L-1.s-1 (Load 2). Ventilatory variables obtained immediately before and after surgery were compared in each group. Baseline ventilation increased postoperatively with greater frequency of breathing and comparable tidal volume (VT). Immediately after the application of resistive load, minute ventilation (VI) significantly decreased both pre- and postoperatively, due primarily to the decrease of VT. During sustained loading, VI gradually increased and reached steady state in 2-3 min. After 5 min of loading, Paco2 returned to the control level with Load 1 whereas with Load 2, it was higher than the control value. The magnitude and time course of reduced ventilation in response to resistive load were identical between pre- and postoperative conditions. We conclude that the ability of maintaining ventilation to imposed inspiratory-flow-resistive loading is well preserved during 1 MAC of isoflurane anesthesia before and after gastrectomy.

UI MeSH Term Description Entries
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005743 Gastrectomy Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed) Gastrectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000403 Airway Resistance Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. Airway Resistances,Resistance, Airway,Resistances, Airway
D000769 Anesthesia, Inhalation Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract. Insufflation Anesthesia,Anesthesia, Insufflation,Inhalation Anesthesia
D013990 Tidal Volume The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. Tidal Volumes,Volume, Tidal,Volumes, Tidal
D015656 Respiratory Mechanics The physical or mechanical action of the LUNGS; DIAPHRAGM; RIBS; and CHEST WALL during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc. Breathing Mechanics,Breathing Mechanic,Mechanic, Breathing,Mechanic, Respiratory,Mechanics, Breathing,Mechanics, Respiratory,Respiratory Mechanic

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