Intravenous versus inhalation anaesthesia for one-lung ventilation

Bassi, Adriana; Milani, WR; Dib, RP El; Atallah, AN; Matos, Délcio

doi:10.1002/14651858.cd006313

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Finally, we limited the language to English, which may increase the risk of publication bias. Thus, as two Cochrane Meta-analysis recommended (3,7), if researchers doubted the prognosis of different anesthetics when OLV, they should design and carry out more high-quality and large-scaled trials to assess the standardized outcomes in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Christopher.U et al found that in cardiac surgery, inhaled anesthesia was associated with major benefits in outcomes and reduced mortality(6). However, Bassi.A(7) and Modolo.NS(3) revealed that few evidence from randomized controlled trials(RCTs) demonstrated significant difference in particular postoperative outcomes between general anesthesia maintained by inhaled and intravenous anesthetics in case of OLV in 2008 and 2013. Later, several RCTs and systematic reviews suggested that inhalation might preserve intraoperative cardiac function, reduce PPCs, attenuate local alveolar inflammatory responses in patients undergoing OLV(8-10).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation

Yang

Cui

Huang

et al. 2022

Preprint

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Introduction? With the widely used technique of One Lung Ventilation (OLV) in patients throughout thoracic surgery, it’s unclear whether inhaled or intravenous anesthetics were associated with postoperative complications. The purpose of the current study is to compare the effects of intravenous and inhaled anesthetics on the postoperative complications within the patients suffering OLV. Methods? We searched the related randomized controlled trials in PubMed\EMBASE\Medline and the Cochrane library up to 09\2021.Inclusive criteria were as follows: We included all the randomized controlled trials which compared the effects of intravenous and inhaled anesthetics on the postoperative complications[listed as: (a) major complications; (b)postoperative pulmonary complications (PPCs); (c) postoperative cognitive function (MMSE score); (d) length of hospital stay; (e) 30-days mortality] for the patients undergoing one lung ventilation. Results? Thirteen randomized controlled trials with 2522 patients were included for analysis. Overall, there were no significant differences in the postoperative major complications between inhaled and intravenous anesthetics groups (OR 0.78, 95%CI 0.54 to 1.13, p =0.19; I 2 =0%). However, more PPCs were detected in intravenous groups when compared to inhaled groups (OR 0.62, 95%CI 0.44 to 0.87, p =0.005; I 2 =37%). Both the postoperative MMSE scores (SMD -1.94, 95%CI -4.87 to 0.99, p =0.19; I 2 =100%) and the length of hospital stay (SMD 0.05, 95%CI -0.29 to 0.39, p =0.76; I 2 =73%) were comparable between two groups. Besides, the 30-day mortality didn’t differ significantly across groups either (OR 0.79, 95%CI 0.03 to 18, p =0.88; I 2 =63%). Conclusions? In patients undergoing OLV, generous anesthesia with inhaled anesthetics could reduce PPCs compared with intravenous anesthetics, but no evident advantages were provided over other major complications, cognitive function, hospital stay or mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation

Yang

Cui

Huang

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Elimination of volatile anesthetic agents and converting to a total intravenous anesthetic has the theoretical advantage of improving hypoxic pulmonary vasoconstriction (HPV), though this is controversial 11,12 and unsupported by a 2008 Cochrane Database review. 13 The intraoperative use of iNO has the potential advantage of reducing shunt fraction by selectively vasodilating only the areas of the lung that are perfused with negligible effects on the systemic circulation. 14 However, issues include cost and the logistics of the additional equipment that is required for its administration, which may not be readily available in all operating rooms.…”

Section: Discussionmentioning

confidence: 99%

Phenylephrine to Treat Hypoxemia during One-Lung Ventilation in a Pediatric Patient

Schloss

Martín

Beebe

et al. 2013

THORAC CARDIOV SURG Reports

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To improve surgical visualization and facilitate the procedure, one-lung ventilation (OLV) is frequently used during thoracic surgery. Although generally well tolerated, the ventilation–perfusion inequality induced by OLV may lead to a decrease in oxygenation and, at times, hypoxemia. Effective treatment algorithms and strategies are necessary for the treatment of hypoxemia during OLV to ensure that the technique can be continued without interruption and allow for completion of the surgical procedure. Treatment strategies may include applying positive end expiratory pressure to the nonoperative lung, continuous positive airway pressure or low flow oxygen insufflation to the operative lung, decreasing anesthetic agents that interfere with hypoxic pulmonary vasoconstriction (HPV), or switching to total intravenous anesthesia. Although less commonly employed, α-adrenergic agonists may also improve oxygenation during OLV by augmenting HPV. We present a 12-year-old girl who developed hypoxemia during OLV, which was not corrected by the usual maneuvers. Hypoxemia was successfully treated with a phenylephrine infusion. The potential applications of α-adrenergic agonists such as phenylephrine in the treatment of hypoxemia during OLV are discussed and its physiologic basis reviewed.

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Lung transplantation: how we do it

Murala¹,

Hanif²,

Peltz³

et al. 2021

Indian J Thorac Cardiovasc Surg

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Lung transplantation is considered the gold standard for patients with chronic end-stage pulmonary disease. However, due to the complexity of management and relatively lower median survival as compared to other solid organs, many programs across the world have been slow to adopt the same. In our institution, we started lung transplantation in September 1990. And since then, we performed close to 900 lung transplantations. Here, we describe in detail the operative steps adopted in our institution for a successful lung transplantation. There have been very few variations over the years. We believe that having a standardized technique is one of the important features for success of a lung transplant program.

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Intravenous versus inhalation anaesthesia for one-lung ventilation

Cited by 3 publications

References 10 publications

Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation

Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation

Phenylephrine to Treat Hypoxemia during One-Lung Ventilation in a Pediatric Patient

Lung transplantation: how we do it

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