Intravenous versus inhalation anaesthesia for one-lung ventilation

Bassi, Adriana; Milani, Wilson Roberto Oliveira; Dib, Regina El; Matos, Délcio

doi:10.1002/14651858.cd006313.pub2

Cited by 12 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They found no evidence regarding the effect of maintenance anesthetic agents on participants’ outcomes (11). In addition, in another similar systematic review done by Bassi et al (12), the same results were obtained. These results were in agreement with our results concerning the similar pressure of arterial oxygen, patients` blood pressure and heart rate in both groups.…”

Section: Discussionsupporting

confidence: 76%

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

Attar¹,

Tabari²,

Rahnamazadeh³

et al. 2014

Iran Red Crescent Med J

View full text Add to dashboard Cite

Background:Hypoxia occurs during one-lung ventilation (OLV) due to the arteriovenous shunt of unsaturated pulmonary venous blood. Hypoxic pulmonary vasoconstriction (HPV) acts as a defense mechanism against shunting. In thoracic surgery, anesthetics with minimal inhibitory effect on HPV and minimal hemodynamic changes are preferred.Objectives:The present study aimed to evaluate the effects of propofol and isoflurane on patients’ arterial oxygen pressure following one-lung ventilation during thoracic surgeries.Materials and Methods:In this randomized clinical trial study which was conducted in Iran, sixty patients with ASA (The American Society of Anesthesiologists) class I & II who were candidates for right elective thoracotomy were divided in two groups. Induction of anesthesia in the two groups was conducted using the same method, and left double-lumen endotracheal tube was inserted. In the first group propofol was used for the maintenance of anesthesia, and isoflurane for the second group. During two-lung ventilation and at minutes 5 and 10 after OLV, ABG (arterial blood gas) (for detecting the mean pressure of arterial oxygen), mean arterial pressure and heart rate were recorded.Results:Sixty patients (mean age = 4124.18 ± 18.63 years) were divided into two groups. The age and gender of the subjects were not statistically different between the two groups. In the propofol group, the arterial oxygen pressure during two-lung ventilation and at 5th and 10th minutes after OLV was 263.14 ± 136.19, 217.40 ± 133.99 and 182.34 ± 122.39; in the isoflurane group, it was reported as 206.29 ± 135.59, 164.78 ± 118.90 and 155.35 ± 109.21 mmHg, respectively. In the propofol group, mean arterial pressure during two-lung ventilation, and 5th and 10th minutes after OLV, was 84.01 ± 20.67, 88.15 ± 20.23 and 86.10 ± 19.13, respectively; regarding the isoflurane group, it was reported as 79.66 ± 17.04, 84.78 ± 20.19 and 86.50 ± 17.07 mmHg, respectively. In the propofol group, heart rate during two-lung ventilation, and 5th and 10th minutes after OLV was 92.77 ± 17.20, 94.0 ± 18.34 and 94.33 ± 21.03, respectively; In the isoflurane group, it was reported as 92.87 ± 16.96, 91.8 ± 18.75 and 91.05 ± 17.20 min, respectively. These values were statistically similar in the two study groups.Conclusions:The effects of propofol on hemodynamics and arterial oxygen pressure during one- or two-lung ventilation were not different from those of isoflurane.

show abstract

Section: Discussionsupporting

confidence: 76%

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

Attar¹,

Tabari²,

Rahnamazadeh³

et al. 2014

Iran Red Crescent Med J

View full text Add to dashboard Cite

show abstract

“…The language is also limited to English, which may increase the risk of publication bias. Therefore, if researchers doubt the prognostic value of different anesthetics during OLV, as recommended by two Cochrane meta-analyses [ 3 , 7 ], then higher quality, more extensive trials should be designed and conducted in the future to evaluate expected outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Christopher, et al found that in cardiac surgery, inhalation anesthesia was associated with a significant outcome advantage and lower mortality [6]. However, Bassi, A [7] and Modolo, NS [3] found little evidence from randomized controlled trials (RCTs) in 2008 and 2013 that showed significant differences in specific postoperative outcomes between general anesthesia maintained with inhalation and intravenous anesthesia such as propofol in the case of OLV. Subsequently, several RCTs and systematic reviews have suggested that inhaled anesthesia may preserve cardiac function, decrease PPC, and attenuate local alveolar inflammatory responses in patients undergoing OLV [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Effects of propofol and inhaled anesthetics on postoperative complications for the patients undergoing one lung ventilation: A meta-analysis

Yang

Huang²,

Cao³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Introduction With the widespread use of one-lung ventilation (OLV) in thoracic surgery, it is unclear whether maintenance anesthetics such as propofol and inhaled anesthetics are associated with postoperative complications. The purpose of this study was to compare the effects of propofol and inhaled anesthetics on postoperative complications in OLV patients. Methods PubMed, EMBASE, Medline, and Cochrane Library were searched for relevant randomized controlled trials until 09/2021. All randomized controlled trials comparing the effect of propofol versus inhaled anesthetics on postoperative complications in OLV patients were included. All randomized controlled trials comparing:(a) major complications (b) postoperative pulmonary complications (c) postoperative cognitive function (MMSE score) (d) length of hospital stay (e) 30-day mortality, were included. Results Thirteen randomized controlled trials involving 2522 patients were included in the analysis. Overall, there was no significant difference in major postoperative complications between the inhaled anesthetic and propofol groups (OR 0.78, 95%CI 0.54 to 1.13, p = 0.19; I2 = 0%). However, more PPCs were detected in the propofol group compared to the inhalation anesthesia group (OR 0.62, 95%CI 0.44 to 0.87, p = 0.005; I2 = 37%). Both postoperative MMSE score (SMD -1.94, 95%CI -4.87 to 0.99, p = 0.19; I2 = 100%) and hospital stay (SMD 0.05, 95%CI -0.29 to 0.39, p = 0.76; I2 = 73%) were similar between the two groups. The 30-day mortality rate was also not significantly different between groups (OR 0.79, 95%CI 0.03 to 18, p = 0.88; I2 = 63%). Conclusions In patients undergoing OLV, general anesthesia with inhaled anesthetics reduced PPC compared to propofol, but did not provide clear benefits on other major complications, cognitive function, length of hospital stay, or mortality.

show abstract

“…Although work published in the 1980s was able to make a clear association between the blunting of hypoxic pulmonary vasoconstriction (HPV) and inhalational anesthetics in rat lungs [20], a recent meta-analysis by Bassi et al [21 ] was unable to demonstrate a benefit of one technique over the other in humans. A study published by De Conno et al [22 ] showed that patients receiving the volatile anesthetic sevoflurane during OLV expressed lower levels of inflammatory mediators than patients receiving a target controlled infusion of propofol.…”

Section: Anesthetic Implicationsmentioning

confidence: 99%