Anaesthesia and Coexisting Diseases: Chronic Obstructive Pulmonary Disease

  • R. Alvisi
  • E. R. Righini
  • C. A. Volta
Conference paper


Knowledge about the prevalence of chronic obstructive pulmonary disease (COPD) is still incomplete, especially in Italy. However, it is estimated that in USA 4 to 6% of adult white male population and 1 to 3% of adult white female population suffer from COPD [1]. Therefore, it is more than a possibility that COPD patients could develop a disease requiring surgery. Moreover, since COPD affects elderly which are more likely to develop diseases due to COPD itself and tobacco abuse, surgery can be associated with increased risk of morbidity and mortality.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Airway Smooth Muscle Functional Residual Capacity Major Vascular Surgery 
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  1. 1.
    Higgins MW, Thorn T (1990) Incidence, prevalence and mortality: intra-and inter-county differences. In: Hensley MJ, Saunders NA (eds) Clinical epidemiology of chronic obstructive pulmonary disease. Marcel Dekker, New York, pp 23–43Google Scholar
  2. 2.
    Kroenke K, Lawrence VA, Theroux JF et al (1993) Postoperative complications after thoracic and major abdominal surgery in patients with and without obstructive lung disease. Chest 104:1445–1451PubMedCrossRefGoogle Scholar
  3. 3.
    ATS Statements (1995) Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 152:S77–120Google Scholar
  4. 4.
    Mahler DA, Weinburg DH, Wells CK et al (1984) The measurement of dyspnea: contents, interobserver agreement and physiologic correlates of two new clinical indexes. Chest 85: 751–758PubMedCrossRefGoogle Scholar
  5. 5.
    ATS statement Lung function testing (1991) Selection of reference values and interpretative strategies (statement). Am Rev Respir Dis 144:1201–1218Google Scholar
  6. 6.
    Celli BR, Rodriguez KS, Snider GL (1984) A controlled trial of intermittent positive pressure breathing, incentive spirometry and deep breathing exercises in preventing pulmonary complication after abdominal surgery. Am Rev Respir Dis 130:12–15PubMedGoogle Scholar
  7. 7.
    Benumof JL, Alfery DD (1986) Anesthesia for thoracic surgery. In: Miller RD (ed) Anesthesia 2nd edn. Churchill Livingstone, New York, pp 1371–1462Google Scholar
  8. 8.
    Hall JC, Tarala R, Harris J et al (1991) Incentive spirometry versus routine chest physiotherapy for prevention of pulmonary complications after abdominal surgery. Lancet 337:953–956PubMedCrossRefGoogle Scholar
  9. 9.
    Ford GT, Rosenal W, Clergue F (1993) Respiratory physiology in upper abdominal surgery. Clin Chest Med 14:227–236Google Scholar
  10. 10.
    MacFadyen BV, Ponsky JL (1992) Laparoscopy for the general surgeon. Surg Clin N Am 72:997–1185Google Scholar
  11. 11.
    Marshall MC, Olsen GN (1993) The physiologic evaluation of the lung resection candidate. Clin Chest Med 14:305–320PubMedGoogle Scholar
  12. 12.
    Markos J, Mullan BP, Hillman DR et al (1989) Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis 139:902–910PubMedGoogle Scholar
  13. 13.
    Nickoladze GD (1992) Functional results of surgery for bullous emphysema. Chest 101: 119–122PubMedCrossRefGoogle Scholar
  14. 14.
    Cooper JD, Trulock EP, Triantafillou An et al (1995) Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg 109:106–119PubMedCrossRefGoogle Scholar
  15. 15.
    Paskin S, Rodam T, Smith TC (1969) The effect of spinal anesthesia of the pulmonary function of patients with chronic obstructive pulmonary disease. Ann Surg 169:35–40PubMedCrossRefGoogle Scholar
  16. 16.
    Hewlett AM, Huilands GH, Nunn JF (1974) Functional residual capacity during anesthesia. II. Spontaneous respiration. Br J Anaesth 46:486–494PubMedCrossRefGoogle Scholar
  17. 17.
    Nunn JF, Coleman AJ, Sachithanandan T (1965) Hypoxaemia and atelectasis produced by forced expiration. Br J Anaesth 37:3–12PubMedCrossRefGoogle Scholar
  18. 18.
    Westbrook PR, Stubbs SE, Sessler AD (1973) Effects of anesthesia and muscle paralysis on respiratory mechanics in normal man. J Appl Physiol 34:81–86PubMedGoogle Scholar
  19. 19.
    Yamamoto K, Morimoto N, Warner DO (1993) Factors influencing the direct actions of volatile anesthetics on airway smooth muscles. Anesthesiology 78:1102–1111PubMedCrossRefGoogle Scholar
  20. 20.
    Namba H, Tsuchida H (1996) Effect of volatile anesthetics with and without verapamile on intracellular activity in vascular smooth muscle. Anesthesiology 84:1465–1474PubMedCrossRefGoogle Scholar
  21. 21.
    Durenil B (1996) Anesthesia et hyperreactivité bronchique. Encycl Med Chir (Elsevier Paris) Anesthesie et Reanimation 36-655-F10, p 8Google Scholar
  22. 22.
    Brown RH, Zerhouni EA, Hirshman CA (1993) Comparison of low concentrations of halothane and isoflurane as bronchodilators. Anesthesiology 78:1097–1101PubMedCrossRefGoogle Scholar
  23. 23.
    Pietak S, Weenig CS, Hickey RF et al (1975) Anesthetic effects on ventilation in patients with chronic obstructive pulmonary disease. Anesthesiology 1975;42:160PubMedCrossRefGoogle Scholar
  24. 24.
    Hirshman CH, McCullough RE, Cohen PJ et al (1975) Hypoxic ventilation drive in dogs during thiopental, ketamine or pentobarbital anesthesia. Anesthesiology 43:628PubMedCrossRefGoogle Scholar
  25. 25.
    Zsigmond EK, Matsuki A, Kothary SP et al (1976) Arterial hypoxemia caused by intravenous ketamine. Anesth Analg 55:311PubMedCrossRefGoogle Scholar
  26. 26.
    Cheng EY, Mazzeo AJ, Bosnjak ZJ et al (1996) Direct relaxant effects of intravenous anesthetics on airway smooth muscle. Anesth Analg 83:162–168PubMedGoogle Scholar
  27. 27.
    Conti G, Dell’Utri D, Vilardi V et al (1993) Propofol induces bronchodilatation in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Acta Anesthesiol Scand 37:105–109CrossRefGoogle Scholar
  28. 28.
    Mehr EH, Lindeman KS (1993) Effects of halothane, propofol and thiopental on peripheral airway reactivity. Anesthesiology 79:290–298PubMedCrossRefGoogle Scholar
  29. 29.
    Gal TJ (1994) Bronchial hyperresponsiveness and anesthesia: physiologic and therapeutic perspective. Anesth Analg 78:559–573PubMedCrossRefGoogle Scholar
  30. 30.
    Tuxen DV, Lane S (1987) The effects of ventilatory pattern on hyperinflation, airway pressures, and circulation in mechanical ventilation of patients with severe airflow obstruction. Am Rev Respir Dis 136:872–879PubMedCrossRefGoogle Scholar
  31. 31.
    Rochester DF, Braun NMT (1985) Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis 132:42–47PubMedGoogle Scholar
  32. 32.
    Mithoefer JC, Keighley JF, Karetzky (1971) Response to arterial PO2 to oxygen administration in chronic pulmonary disease: interpretation of findings in a study of 46 patients and 14 normal subjects. Ann Intern Med 74:328–335PubMedGoogle Scholar
  33. 33.
    Righini ER, Cocciolo F, Santini M et al (1994) La gestione postoperatoria del paziente anziano. Decorso postoperatorio, morbilità e sopravvivenza a breve termine. Minerva Anestesiol 60[Suppl] 1:31–41Google Scholar
  34. 34.
    Cullen DJ, Nemeskal AR, Cooper JB et al (1992) Effect of pulse oximetry, age and ASA Physical Status on the frequency of patients admitted unexpectedly to a postoperative intensive care unit and the severity of their anesthesia related complications. Anesth Analg 74: 181–188PubMedCrossRefGoogle Scholar
  35. 35.
    Slutsky S (1993) Mechanical ventilation. Chest 104:1833–1859PubMedCrossRefGoogle Scholar
  36. 36.
    Marini JJ, Capps JS, Culver BH (1985) The inspiratory work of breathing during assisted mechanical ventilation. Chest 87:612–618PubMedCrossRefGoogle Scholar
  37. 37.
    Marini JJ (1991) Weaning from mechanical ventilation. N Engl J Med 324:1496–1498PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • R. Alvisi
    • 1
  • E. R. Righini
    • 1
  • C. A. Volta
    • 1
  1. 1.Dept. of Anaesthesia and Intensive CareUniversity of FerraraFerraraItaly

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