Oxygenation during one-lung ventilation with propofol or sevoflurane

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Respiratory Physiology

Background:

• One-lung ventilation (OLV) is crucial for thoracic surgery but can cause respiratory and hemodynamic challenges.
• Choosing the optimal anesthetic technique for OLV is essential for patient safety and surgical outcomes.

Purpose of the Study:

• To compare the effects of intravenous propofol versus inhalational sevoflurane anesthesia on hemodynamic and respiratory parameters during OLV.
• To evaluate oxygenation differences between the two anesthetic techniques during thoracic surgery.

Main Methods:

• A randomized study involving 60 patients (ASA I-III) undergoing thoracic surgery with OLV.
• Patients received either propofol (intravenous) or sevoflurane (inhalational, 1 MAC).
• Hemodynamic, respiratory, and blood gas parameters were measured during two-lung ventilation and at 10, 20, and 30 minutes after OLV initiation.

Main Results:

• Both propofol and sevoflurane anesthesia groups exhibited comparable hemodynamic and respiratory parameters throughout the study.
• Oxygenation levels did not significantly differ between the intravenous and inhalational anesthesia groups when mean arterial blood pressure was maintained consistently.
• Propofol dosage was titrated to maintain mean arterial pressure between 75-80 mmHg.

Conclusions:

• Both intravenous propofol and inhalational sevoflurane are suitable anesthetic agents for thoracic surgery involving one-lung ventilation.
• Neither technique demonstrated superiority in maintaining hemodynamic stability or oxygenation during OLV.
• Anesthesiologists can confidently select either propofol or sevoflurane for OLV based on patient-specific factors.