The Effect Of Salbutamol Inhalation Preoperatively On Intraoperative Respiratory Function And Postoperative Pulmonary Complications In COPD Patients Underlying One Lung Ventilation Thoracic Surgery

The incidence and mortality of lung cancer have been ranked the first among malignant tumors,and most patients with chronic obstructive pulmonary disease(COPD).Surgical resection is still the most effective treatment for lung cancer.In order to obtain a better surgical field and protect the healthy side of the lung,lung isolation technology is often used in thoracic surgery to meet the surgical needs.Hypoxemia often occurs during pulmonary isolation and single lung ventilation.Increasing inhaled oxygen concentration is a common treatment to improve hypoxemia during one-lung ventilation,but inhaling high concentration oxygen can aggravate oxidative stress injury and lung injury caused by one-lung ventilation.Postoperative pulmonary co mplications are the main adverse events that affect the recovery of patients undergoing thoracic surgery and increase the medical burden of patients.The incidence of PPCs in COPD patients is higher than that in non-COPD patients.Salbutamol sulfate can not only dilate bronchi,improve airflow limitation in COPD patients,but also inhibit a variety of inflammatory factors on lung injury.Therefore,this study aims to explore the effects of preoperative inhalation of salbutamol solution on pulmonary function during single-lung ventilation and postoperative pulmonary complications in patients undergoing thoracic surgery,providing reference for the prevention of hypoxemia and postoperative pulmonary complications in patients with COPD during surgical anesthesi a.Objective: to investigate the effects of single aerosol inhalation of salbutamol 30 min before chest surgery on pulmonary function and postoperative complications in COPD patients.Methods: From December 2020 to June 2021,100 COPD patients who were hospitalized in thoracic surgery department of Tangdu Hospital and planned to undergo pulmonary lobectomy/segmental pulmonary resection were selected as the research objects,and randomly divided into control group and experimental group,50 cases in each gro up.Preoperative routine abstaining from drinking and fasting.After being connected to the operating room on the day of surgery,the experimental group was given salbutamol sulfate solution(5mg: 2.5m L)atomized(spray atomizer,flow rate 6-8L /min)inhal ation 30 min before induction of anesthesia,while the control group was a blank control,without special treatment,and received conventional anesthesia.Radial artery blood was extracted for blood gas analysis(Pa O2,Pa CO2,c[K+],c[Lac])before induction of anesthesia(T1),after endotracheal intubation(T2),single lung ventilation for 30min(T3),and at the end of surgery(T4).MAP,HR and Ppeak of patients at each time point were recorded.After discharge,electronic medical record system was u sed to record and analyze the occurrence of postoperative pulmonary complications,and analyze the economic situation such as hospitalization costs.Results: MAP at T2,T3 and T4 was lower than that at T1(P<0.05).The oxygenation index at T3 was lower tha n that at T1,T2 and T4(P<0.05).The Ppeak at T3 was higher than that at T2 and T4(P<0.05).Compared with control group,HR of test group was higher than control group at all time(P<0.05);The Ppeak of test group at T2 was lower than that of control group,and the oxygenation index of test group at T3 was higher than that of control group.There was no statistical significance in postoperative complications and hospitalization costs between the two groups(P>0.05).Conclusion: Inhalation of nebulized salbut amol 30 min before surgery in patients with chest COPD can reduce airway peak pressure,improve oxygenation function,reduce the occurrence of hypoxemia,and help improve perioperative lung function.