[Effects of a respiratory analeptic with peripheral action-almitrine on ventilation immediately after surgery]

After a brief review of the advantages and disadvantages of the postoperative administration of a respiratory analeptic with a central action, the authors study the effects of almitrine (respiratory analeptic with a peripheral action) on alveolar ventilation following thoracic surgery. Two groups of 10 patients were distinguished: the patients of the first group received almitrine (1.5 mg/kg-1 over a period of one hour) thirty minutes after their return from the operating room, whilst those of the second group received no respiratory analeptic. Blood gases were measured 30 minutes after the return from the operating room (immediately before the start of the infusion of almitrine) then 1 hour, 2 hours and 3 hours later. The improvement in blood gases after almitrine was significant: whilst arterial pCO2 was a mean of 5.78 kPa (44.46 mmHg) in the control subjects, it fell 4.99 kPa (38.4 mmHg) by the end of the infusion in the tested subjects and subsequently remained at a mean of 5.04 kPa (38.79 mmHg). Arterial pO2 measured with FIO2 in all patients remained stable in the control subjects during the three hours postoperatively (mean = 15.11 kPa (116.26 mmHg). In the tested subjects, it improved progressively and significantly, rising from 11.08 kPa (85.2 mmHg) before almitrine to 14.05 kPa (108 mmHg) at the end of the infusion, then to 15.95 kPa (122.7 mmHg) 1 hour later and to 16.51 kPa (127 mmHg) 2 hours later. The authors concluded that almitrine is effective in the treatment of early alveolar hypoventilation after thoracic surgery in patients receiving moderate doses of oxygen (FIO2 = 0.40).