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Doxapram improves pulmonary function after upper abdominal surgery
Author(s) -
Björk L.,
Arborelius M.,
Renck H.,
Rosberg B.
Publication year - 1993
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1993.tb03697.x
Subject(s) - doxapram , medicine , anesthesia , pulmonary function testing , ventilation (architecture) , dead space , surgery , placebo , mechanical ventilation , mechanical engineering , engineering , alternative medicine , pathology
The effects of doxapram on postoperative pulmonary function were studied in 40 ASA I and II patients randomly allocated to receive either doxapram 1.8 mg· kg ‐1 . h ‐1 or placebo for 2 h immediately after elective cholecystectomy. The two groups displayed similar reductions of carbon dioxide production at 2 h and 6 h postoperatively, whereas oxygen consumption remained at preoperative levels for 24 h. Minute ventilation was similarly reduced in the two groups at 2 h and 6 h postoperatively, with corresponding increases in Paco 2 . Pao 2 was similarly and significantly decreased in both groups postoperatively, whereas P(A‐a)o 2 remained unchanged at 2 h and 6 h in doxapram‐treated patients. FRC was reduced postoperatively in both groups, significantly more so in the control group at 6 h. Various indices of intrapulmonary gas distribution, including the functional (nitrogen) dead space, underwent similar changes in the two groups. By contrast, the physiological dead space was reduced in doxapram‐treated patients at 2 h, 6 h and 24 h postoperatively, whereas no significant changes were seen in the control group. The ventilatory equivalent for CO 2 was significantly lower in the doxapram‐treated group, implying higher ventilatory efficiency. Our findings indicate that infusion of doxapram postoperatively attenuates the impairment of pulmonary function postoperatively, chiefly via effects on V' A /Q' ratios. No side effects of doxapram were observed.