title: Use of tiotropium bromide for pre-operative treatment in chronic obstructive pulmonary disease patients: comparison with oxitropium bromide.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD), which ranks fifth in terms of the global burden of diseases, is one of the major risk factors of post-operative pulmonary complications. Tiotropium bromide is a new inhaled bronchodilator for COPD patients with a sustained duration of action; it has superior efficacy compared to other bronchodilators. However, little is known regarding its clinical value as a preoperative treatment for COPD patients. In this study, we compared the incidence of post-operative complications between COPD patients who received with tiotropium bromide and those who did not.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  For 1 month before surgery we examined 84 and 82 patients treated with tiotropium bromide (tiotropium group) and oxitropium bromide (oxitropium group), respectively, in combination with other medications. We performed a statistical comparison of clinical features, pulmonary functions, and postoperative complications between the 2 groups.
  
  
  RESULTS
  The improvements in clinical symptoms and forced expiratory volume in 1 second were better in the tiotropium group than in the oxitropium group. The incidence of post-operative pulmonary complications (refractory bronchospasm, pulmonary infection, and acute respiratory failure) was significantly lower in the tiotropium group than in the oxitropium group. Three patients in the tiotropium group complained of dry mouth; however, the symptoms could be controlled. The incidence of post-operative non-pulmonary complications was not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  We propose that tiotropium bromide might be a safe and useful drug for pre-operative treatment of COPD patients.
authors.affiliation: Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital. vega@xa2.so-net.ne.jp
authors.forename: Wataru
authors.initials: W
authors.lastname: Matsuyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitsuyama
authors.forename: Yoshimizu
authors.initials: Y
authors.lastname: Koreeda
authors.forename: Ikkou
authors.initials: I
authors.lastname: Higashimoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Osame
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D000069447:Tiotropium Bromide