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Effects of thoracic epidural meperidine on arterial oxygenation during one-lung ventilation in thoracic surgery
Ignacio Garutti1, Patricia Cruz, Luis Olmedilla
1Department of Anesthesiology and Reanimation, Hospital General, "Gregorio Marañon", Madrid, Spain. ngarutti@inicia.es
Objective:
To compare the effects that the use of general intravenous anesthesia (propofol-fentanyl) (GA) or general anesthesia combined with thoracic epidural anesthesia with meperidine (TEA-M) may have on arterial oxygenation during one-lung ventilation (OLV).
Design:
Prospective.
Setting:
Tertiary care hospital.
Participants:
Seventy-two patients undergoing OLV for thoracic surgery.
Interventions:
Patients were prospectively randomized into two groups: GA (n = 37) fentanyl, propofol, rocuronium anesthesia was used; and group TEA-M (n = 35) were anesthetized with propofol, rocuronium and thoracic epidural meperidine (2 mg/kg in 10-12 mL) administered before anesthetic induction. A double-lumen endotracheal tube was inserted, and mechanical ventilation with 100% oxygen was used during study. Mean arterial pressure, heart rate and arterial and venous blood gases were recorded with the patients in the lateral decubitus position in three phases: during two-lung ventilation (TLV), 15 and 30 minutes after beginning OLV (OLV + 15 and OLV + 30 respectively). The authors measured arterial and venous central oxygen tension, arterial and venous central oxygen saturation, arterial and venous central oxygen content and venous admixture percentage (Qs/Qt%).
Measurements And Main Results:
There were no statistical differences between the two groups for PaO(2) during OLV + 15 (GA = 165 mmHg, TEA-M = 153 mmHg) and OLV + 30 (GA = 176 mmHg, TEA-M = 158 mmHg); and with values for Qs/Qt%.
Conclusions:
It is concluded that GA combined with TEA-M (2 mg/kg) do not affect arterial oxygenation during OLV in thoracic surgery.
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