To evaluate the application value of budesonide combined with inhaled compound ipratropium bromide in perioperative airway management in elderly patients undergoing 4 types of laparoscopic surgery.

83 elderly patients undergoing laparoscopic surgery in the First Affiliated Hospital of Anhui University of Science and Technology from January 2021 to September 2022 were enrolled. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 58 patients were male and 25 female, aged from 60 to 88 years, with a median age of 70 years. All patients were divided into the observation group (n=35) and control group (n=48) according to the random number table method. In the observation group, compound ipratropium bromide combined with budesonide suspension inhalation was given from 3 d before surgery to 7 d after surgery. In the control group, saline inhalation was given. The changes of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1.0%) before and after surgery in two groups were analyzed by repeated measures analysis of variance. The incidence of postoperative pulmonary complications (PPCs) between two groups was compared by Chi-square test. The length of hospital stay and total expense were compared by Mann-Whitney U test.

Repeated measures analysis of variance showed that the differences in the FVC and FEV1.0% were statistically significant between the observation and control groups (F=4.826, 7.340; P<0.05). The overall change trends of FVC and FEV1.0% in the observation group were significantly better than those in the control group (F=256.728, 65.699; P<0.05). The incidence rates of postoperative respiratory symptoms in the observation and control groups were 34%(12/35) and 56%(27/48), and 26%(9/35) and 48%(23/48) for PPCs, with statistical significance (χ²=3.920, 4.212; P<0.05). In the observation and control groups, the total length of hospital stay were 19(15, 27) d and 22(19, 28) d, and 53 000(44 000, 65 000) Yuan and62 000(53 000, 78 000) Yuan for the total hospitalization expenses, with statistical significance (Z=-2.263,-2.896; P<0.05).

The incidence of PPCs is high in elderly patients after laparoscopic surgery. Perioperative use of compound ipratropium bromide combined with budesonide suspension inhalation can effectively improve lung function reserve, thereby decreasing the incidence of PPCs, shortening the total length of hospital stay and mitigating the economic burden.