Non-asthmatic patients show increased exhaled nitric oxide concentrations.
OBJECTIVE
Evaluate whether exhaled nitric oxide may serve as a marker of intraoperative bronchospasm.


BACKGROUND
Intraoperative bronchospasm remains a challenging event during anesthesia. Previous studies in asthmatic patients suggest that exhaled nitric oxide may represent a noninvasive measure of airway inflammation.


METHODS
A total of 146,358 anesthesia information forms, which were received during the period from 1999 to 2004, were reviewed. Bronchospasm was registered on 863 forms. From those, three groups were identified: 9 non-asthmatic patients (Bronchospasm group), 12 asthmatics (Asthma group) and 10 subjects with no previous airway disease or symptoms (Control group). All subjects were submitted to exhaled nitric oxide measurements (parts/billion), spirometry and the induced sputum test. The data was compared by ANOVA followed by the Tukey test and Kruskal-Wallis followed by Dunn's test.


RESULTS
The normal lung function test results for the Bronchospasm group were different from those of the asthma group (p <0.05). The median percentage of eosinophils in induced sputum was higher for the Asthma [2.46 (0.45-6.83)] compared with either the Bronchospasm [0.55 (0-1.26)] or the Control group [0.0 (0)] (p <0.05); exhaled nitric oxide followed a similar pattern for the Asthma [81.55 (57.6-86.85)], Bronchospasm [46.2 (42.0 -62.6] and Control group [18.7 (16.0-24.7)] (p< 0.05).


CONCLUSIONS
Non-asthmatic patients with intraoperative bronchospasm detected during anesthesia and endotracheal intubation showed increased expired nitric oxide.
Saraiva-Romanholo
Beatriz M
BM
Department of Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Machado
Fabio S
FS
Almeida
Francine M
FM
Nunes
Maria do Patrocínio T
Mdo P
Martins
Milton A
MA
Vieira
Joaquim E
JE
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000758:Anesthesia / Q000009:adverse effects*; D000769:Anesthesia, Inhalation; D001249:Asthma / Q000175:diagnosis; D001986:Bronchial Spasm / Q000139:chemically induced* / Q000175:diagnosis; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000032:analysis; D016022:Case-Control Studies; D004804:Eosinophils; D045853:Exhalation / Q000187:drug effects*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000009:adverse effects / Q000032:analysis*; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000009:adverse effects / Q000032:analysis*; D013147:Spirometry; D013183:Sputum / Q000737:chemistry; D055815:Young Adult
D001993:Bronchodilator Agents; D018836:Inflammation Mediators; D009569:Nitric Oxide