Effects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery

Pang, Qianyun; An, Ran; Liu, Hongliang

doi:10.23736/s0375-9393.18.12501-6

Cited by 20 publications

(20 citation statements)

References 31 publications

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“…In Italy 1 or the United Kingdom, 2 inhalation anesthesia was preferred by the majority of hospitals in thoracic anesthesia, since it can decrease alveolar inflammation during one-lung ventilation 3 and decrease postoperative pulmonary complications, although it has been shown to increase pulmonary shunt fraction during one-lung ventilation. 4 So inhalational anesthesia should be considered for thoracic surgery, as it has so many advantages over intravenous anesthesia. In 1 hospital in Chongqing city, a nonintubation technique with spontaneous breathing was used for nearly all patients.…”

Section: To the Editormentioning

confidence: 99%

A Survey of Thoracic Anesthesia Practice in Chongqing City, China

Liu

Yang

Chen

2019

Journal of Cardiothoracic and Vascular Anesthesia

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Section: To the Editormentioning

confidence: 99%

A Survey of Thoracic Anesthesia Practice in Chongqing City, China

Liu

Yang

Chen

2019

Journal of Cardiothoracic and Vascular Anesthesia

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“…Two meta-analyses reported that inhalation anaesthesia could reduce proinflammatory factors in the alveoli during pneumonectomy and decrease postoperative pulmonary complications. [ 33 , 34 ] However, in this meta-analysis, propofol anaesthesia was better than inhalation anaesthesia for the attenuation of cognitive impairment and systemic inflammation.…”

Section: Discussionmentioning

confidence: 83%

Effects of inhalation and propofol anaesthesia on postoperative cognitive dysfunction in elderly noncardiac surgical patients

Pang¹,

Duan²,

Jiang³

et al. 2021

Medicine

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Background: Postoperative cognitive dysfunction (POCD) is a very common event in elderly noncardiac surgical patients. The effects of inhalational anaesthetics and propofol on the incidence of POCD and postoperative cognitive status at different time points after surgery are currently unclear.Methods: We searched the Embase, Medline, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs), in which inhalation anaesthesia and propofol anaesthesia were compared. The incidence of POCD or postoperative cognitive status was assessed in elderly patients undergoing noncardiac surgery.Results: Fifteen RCTs with 1854 patients were included in this meta-analysis. The incidence of POCD on postoperative Days 2-6 after propofol anaesthesia was markedly lower than that after inhalation anaesthesia (risk ratio (RR): 0.37, 95% confidence interval (CI): 0.15-0.88, P = .025), and Mini-Mental State Examination (MMSE) scores after propofol anaesthesia were substantially higher than those after inhalation anaesthesia (standard mean difference (SMD): 0.59, 95% CI: 0.07-1.11, P = .026). The levels of interleukin-6 (IL-6) and tumour necrosis factor-a (TNF-a) were much lower after propofol anaesthesia than after inhalation anaesthesia (SMD: -2.027, 95%

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“…found a moderate quality evidence in favor of inhalational anesthesia as compared to intravenous anesthesia in elective thoracic surgeries, when pulmonary complications were analyzed in 9 RCTs. [ 28 ] For the outcome of pulmonary complications, the included studies had less heterogeneity (I 2 = 4%). However, the study by Tsuchiya et al .…”

Section: Resultsmentioning

confidence: 99%

“…oxygenation index within 30 minutes of OLV was found significantly higher in intravenous anesthesia group as compared to inhalational group ( P = 0.001), however, there was no significant difference between two groups after 30 minutes of OLV ( p = 0.38). [ 28 ]…”

Section: Resultsmentioning

confidence: 99%

Inhalational versus intravenous anesthetics during one lung ventilation in elective thoracic surgeries: A narrative review

2021

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The anesthesia regimen used during one lung ventilation (OLV) carry the potential to affect intra-operative course and post-operative outcomes, by its effects on pulmonary vasculature and alveolar inflammation. This narrative review aims to understand the pathophysiology of acute lung injury during one lung ventilation, and to study the effects of inhalational versus intravenous anaesthetics on intraoperative and post-operative outcomes, following thoracic surgery. For this purpose, we independently searched 'PubMed', 'Google Scholar' and 'Cochrane Central' databases to find out randomized controlled trials (RCTs), in English language, which compared the effects of intravenous versus inhalational anaesthetics on intraoperative and post-operative outcomes, in elective thoracic surgeries, in human beings. In total, 38 RCTs were included in this review. Salient results of the review are- Propofol reduced intraoperative shunt and maintained better intraoperative oxygenation than inhalational agents. However, use of modern inhalational anaesthetics during OLV reduced alveolar inflammation significantly, as compared to propofol. Regarding post-operative complications, the evidence is not conclusive enough but slightly in favour of inhalational anaesthetics. Thus, we conclude that modern inhalational anaesthetics, by their virtue of better anti-inflammatory properties, exhibit lung protective effects and hence, seem to be safe for maintenance of anesthesia during OLV in elective thoracic surgeries. Further research is required to establish the safety of these agents with respect to long term post-operative outcomes like cancer recurrence.

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Effects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery

Cited by 20 publications

References 31 publications

A Survey of Thoracic Anesthesia Practice in Chongqing City, China

A Survey of Thoracic Anesthesia Practice in Chongqing City, China

Effects of inhalation and propofol anaesthesia on postoperative cognitive dysfunction in elderly noncardiac surgical patients

Inhalational versus intravenous anesthetics during one lung ventilation in elective thoracic surgeries: A narrative review

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