Effects of propofol vs sevoflurane on arterial oxygenation during one-lung ventilation

Abstract

Background. The inhibitory effect of anaesthetic agents on hypoxic pulmonary vasoconstriction may depend upon their dose, especially when using a volatile agent. The aim of this randomized open study was to compare the effects of sevoflurane and propofol, as primary anaesthetic agents, on oxygenation during one-lung ventilation (OLV), with their administration being adjusted to maintain bispectral index (BIS) values between 40 and 60.

The Effects of Intravenous Hyperoxygenated Solution Infusion on Systemic Oxygenation and Intrapulmonary Shunt During One-Lung Ventilation in Pigs

“…The values of PaO 2 , SaO 2 , PvO 2 , SvO 2 , and CvO 2 in H group at both OLVþ30 and OLVþ60 were significantly higher than those in C group (*P < 0.05, z P < 0.01, compared with C group). approaches the mixed venous oxygen tension (PvO 2 ) [11]. PvO 2 is the important factor that may modify the HPV response during OLV.…”

Step-by-step clinical management of one-lung ventilation: Continuing Professional Development

“…3 Dose-dependent inhibition of HPV has been shown with the older inhaled anesthetics (halothane, nitrous oxide) 4 but is less well documented with the newer agents (desflurane, sevoflurane). 6,7 Other factors affecting HPV include systemic and pulmonary vasodilators, acid/base imbalance, and variations in cardiac output. 3,4 Complications Hypoxemia In the early days of thoracic anesthesia, hypoxemia was encountered in as many as 40% of cases with a Carlens double-lumen tube and manual ventilation.…”

“…The newer inhalation anesthetics, desflurane and sevoflurane, however, appear to have lesser effects on HPV and provide equivalent oxygenation compared with propofol at similar anesthetic depths. 7 Furthermore, inhalational anesthetics appear to be lung protective. With OLV, a pro-inflammatory reaction takes place, exhibited by increased cytokine levels in bronchoalveolar lavage samples in either lung.…”

Arterial Oxygenation and Management of Hypoxemia During VATS

“…Volatile anesthetic agents are known to inhibit HPV; however, the impact is minimal at less than 1 MAC and negligible with newer agents [22]. A recent Cochrane review of intravenous versus inhalational anesthesia for OLV concluded that there was very little evidence from randomized controlled trials to suggest differences in patient outcomes between groups [23 • ].…”