A comparison of the effects of propofol-alfentanil versus isoflurane anesthesia on arterial oxygenation during one-lung ventilation.

Abstract

OBJECTIVE:

To determine whether intravenous propofol-alfentanil anesthesia provides superior arterial oxygenation (Pao2) during one-lung ventilation (OLV) compared with isoflurane inhalation anesthesia.

DESIGN:

A prospective, randomized, cross-over study.

SETTING:

Tertiary-care university hospital.

PARTICIPANTS:

Thirty adults having either thoracoscopic pulmonary surgery or esophageal surgery.

INTERVENTIONS:

Patients received either propofol-alfentanil infusion anesthesia or one minimum alveolar concentration (MAC) of isoflurane during the initial period of two-lung ventilation and the first 30 minutes of OLV and then were switched to the other anesthetic for the duration of OLV.

MEASUREMENTS AND MAIN RESULTS:

Arterial blood gases and hemodynamics were recorded during two-lung ventilation and after 20 and 30 minutes of OLV with each anesthetic technique. The mean values (+/- SD) for Pao2 during propofol-alfentanil anesthesia after 20 minutes (222 +/- 100) and 30 minutes (228 +/- 102 mmHg) of one-lung ventilation were not significantly different than after 20 minutes (213 +/- 99) or 30 minutes (214 +/- 96 mmHg) of isoflurane; beta error less than 0.1. Mean heart rate was lower during intravenous (78 +/- 15 min) than inhalation (85 +/- 17 min) anesthesia (rho = 0.03).

CONCLUSION:

This study does not support the theory that total intravenous anesthesia will decrease the risk of hypoxemia during OLV.

• Authors: C W Reid, P D Slinger, S Lenis
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 10 Issue 7 Pg. 860-3 (Dec 1996) ISSN: 1053-0770 [Print] United States
• PMID: 8969391 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Inhalation
• Anesthetics, Intravenous
• Alfentanil
• Isoflurane
• Oxygen
• Propofol

Topics

• Adult
• Aged
• Aged, 80 and over
• Alfentanil (administration & dosage)
• Anesthesia
• Anesthetics, Inhalation (pharmacology)
• Anesthetics, Intravenous (administration & dosage)
• Arteries
• Cross-Over Studies
• Humans
• Hydrogen-Ion Concentration
• Isoflurane (pharmacology)
• Middle Aged
• Oxygen (blood)
• Propofol (administration & dosage)
• Prospective Studies
• Ventilators, Mechanical