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Propofol and alfentanil anesthesia during one-lung ventilation
1Department of Anaesthesiology, University of Stellenbosch Medical School, Tygerberg, Republic of South Africa.
Journal of Cardiothoracic Anesthesia
|April 1, 1990
Summary
This study shows that total intravenous anesthesia with propofol and alfentanil is effective for lung surgery. The technique maintained stable vital signs and good recovery, even during one-lung ventilation.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pharmacology
Background:
- Total intravenous anesthesia (TIVA) is an alternative to volatile anesthesia.
- Optimizing anesthetic techniques for major thoracic surgery is crucial.
Purpose of the Study:
- To evaluate the efficacy and safety of a TIVA technique using propofol and alfentanil for lobectomy or pneumonectomy.
- To assess hemodynamic stability and recovery characteristics during one-lung ventilation.
Main Methods:
- A TIVA technique combining propofol and alfentanil with 100% oxygen ventilation was used in 14 patients.
- Propofol dosage was adjusted to maintain anesthetic depth, while alfentanil was infused at a constant rate.
- Hemodynamic parameters, blood gas values, oxygen saturation, and shunt fraction were monitored.
Main Results:
- The TIVA technique proved effective and easily controllable, maintaining stable blood pressure and pulse rates.
- Satisfactory blood gas values and oxygen saturation were observed throughout the procedure.
- A smaller than expected increase in shunt fraction was noted during one-lung ventilation, with good recovery characteristics.
Conclusions:
- TIVA with propofol and alfentanil is a viable anesthetic option for major lung resections.
- This technique ensures hemodynamic stability and adequate oxygenation, even during one-lung ventilation.
- The observed shunt fraction increase suggests improved V/Q matching during TIVA.