The Effect of Low- Flow Anesthesia on Hemodynamic Parameters and Gas Consumption in Single Lung Ventilation

Abstract

Objective:We aimed to compare the effects of low and medium high-flow anesthesia on hemodynamic parameters, blood gas values and gas consumption in patients undergoing single lung ventilation. Methods: We studied 40 patients over 18 years of age in ASA I-III group who underwent elective thoracic surgery by single lung ventilation. The patients were intubated with doublelumen tube (DLT) following induction of anesthesia. We randomly divided the patients into two groups. In Group 1, 1L/min (80% oxygen+20% air) 4-6% desflurane; in Group 2, 2L/min (80% oxygen+20% air) was applied. Peripheral oxygen saturation, end-tidal carbon dioxide levels, heart rate, invasive blood pressure values, tidal volume, respiration rate, FiO2, fresh gas flow rate values during single lung ventilation in both groups were recorded. Arterial Blood Gas analysis was performed at 1 hour intervals. The amount of desflurane used at the end of single lung ventilation was monitored by anesthesia device. Results: Desflurane consumption was significantly lower in Group 1 (55.3±18.4 vs. 84.9±37.6,p=0.003). EtCO2 was found to be statistically significantly lower in Group 2, especially between 30 and 75 minutes, and systolic, diastolic, and mean arterial pressure between 45 and 120 minutes. There was no significant difference between the groups in terms of NIRS. Only in both left and right NIRS there was a significant elevation in Group 1 at 120 minutes (p=0.08 and p=0.06, respectively). Conclusion: Low flow with desflurane using appropriate equipment and close monitoring can be safely applied without side effects.