Intravenous alprostadil, an analog of prostaglandin E1, prevents thiamylal-fentanyl-induced bronchoconstriction in humans.
Prostaglandin (PG) E(1) relaxes airway smooth muscle in animals. However, no clinical data have been published on the bronchorelaxant effects of IV alprostadil, an analog of PGE(1). We have described experimental thiamylal-fentanyl-induced bronchoconstriction in humans; we now report the effect of IV alprostadil on thiamylal-fentanyl-induced bronchoconstriction. Thirty-two patients were allocated randomly to a control group (n = 16) and alprostadil group (n = 16). Anesthesia was induced with thiamylal 5 mg/kg and vecuronium 0.3 mg/kg and maintained with a continuous infusion of thiamylal 15 mg. kg(-1). h(-1). The lungs of the patients were ventilated with 50% nitrous oxide in oxygen. Twenty minutes after the induction of anesthesia, patients in the control group were given a continuous infusion of normal saline 20 mL/h, and those in the alprostadil group received a continuous infusion of alprostadil 0.2 micro g. kg(-1). min(-1) (20 mL/h), both for 60 min. Both groups were then given fentanyl 5 micro g/kg. Systolic and diastolic arterial blood pressure, heart rate, mean airway resistance (Rawm), expiratory airway resistance (Rawe), and dynamic lung compliance (Cdyn) were measured at the baseline, just before the fentanyl injection (T30), at three consecutive 6-min intervals after fentanyl injection (T36, T42, and T48), and 30 min after fentanyl injection (T60). Baseline Rawm, Rawe, and Cdyn values were comparable between groups. In the control group, both Rawm and Rawe were significantly increased at T36-60, and Cdyn was significantly decreased at T36-60 compared with the baseline. Patients given alprostadil showed no change in Rawm, Rawe, or Cdyn at T36-60. Thus, IV alprostadil seems to have a bronchodilator effect in humans.


CONCLUSIONS
IV alprostadil, an analog of prostaglandin E(1), prevents thiamylal-fentanyl-induced bronchoconstriction in humans. This finding suggests that IV alprostadil has a bronchodilator effect.
Wajima
Zen'ichiro
Z
*Department of Anesthesia, Chiba Hokusoh Hospital, Chiba, Japan; †Department of Anesthesia, Tama-Nagayama Hospital; ‡Department of Anesthesiology, Nippon Medical School; §Department of Anesthesiology, Tokyo Jikeikai Medical School, Tokyo, Japan; and ∥Center for Anesthesiology Research, The Cleveland Clinic Foundation, Ohio.
Shiga
Toshiya
T
Yoshikawa
Tatsusuke
T
Ogura
Akira
A
Imanaga
Kazuyuki
K
Inoue
Tetsuo
T
Ogawa
Ryo
R
D000328:Adult; D000403:Airway Resistance / Q000187:drug effects; D000527:Alprostadil / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D016084:Bronchoconstriction / Q000187:drug effects* / Q000502:physiology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004837:Epinephrine / Q000097:blood; D005260:Female; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008170:Lung Compliance; D008297:Male; D009638:Norepinephrine / Q000097:blood; D013840:Thiamylal / Q000009:adverse effects*
D018686:Anesthetics, Intravenous; D001993:Bronchodilator Agents; D013840:Thiamylal; D000527:Alprostadil; D005283:Fentanyl; D009638:Norepinephrine; D004837:Epinephrine