Objective: To compare the bronchodilatory effect of salbutamol delivered by metered-dose inhaler connected to spacers with and without previous antistatic treatment. Design: Prospective, randomized, open, crossover study. Setting: Outpatients from The Pulmonary Clinic of Hospital Júlia Kubitschek-FHEMIG, Belo Horizonte, Minas Gerais, Brazil. Patients and methods: Eleven patients, with stable mild to moderate asthma were randomized to four inhalation tests of 100 mug of salbutamol: (A) open mouth, (B) non antistatic small volume spacer (50 ml), (C) antistatic small volume spacer (50 ml) and (D) antistatic Fisonair<FONT FACE=Symbol>Ò</FONT> (750 ml). The antistatic treatment consisted in soaking the spacer in a solution of water and detergent for ten minutes and letting it to drip dry without rinsing. Main outcome measure: The peak expiratory flow (PEF) variation 15 minutes after each test in absolute, % of predicted and % of baseline values. Results: The median (Min-Max) PEF absolute variation was 25 (5-85), 40 (0-70), 70 (25-83) and 60 (15-90) l/min for tests A, B, C and D, respectively. The median PEF % baseline variation was 7.6, 11.0, 15.0, 13.3, and median PFE % predicted variation was 6.0, 8.7, 12.7 and 10.7 for tests A, B, C and D, respectively. The results of tests C and D were significantly superior to those of tests A and B (p < 0.01) based on the three methods evaluated. There was no significant difference between the results of tests C and D. Conclusion: The antistatic treatment of a small volume spacer device using a solution of water and detergent can improve the antiasthmatic effect of inhaled drugs delivered by metered-dose inhaler, as occurred with the salbutamol in this study. This fact can be more relevant concerning the treatment with inhaled steroids for asthma.
Asthma; Respiratory therapy; Aerosols; Albuterol
