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[Ketamine versus propofol during one-lung ventilation in thoracic surgery]
Anesteziologiia I Reanimatologiia
|September 22, 2012
Summary
This study compared anesthetic techniques for thoracic surgery, finding propofol-based anesthesia better maintained hemodynamic stability during one-lung ventilation (OLV). Ketamine-based anesthesia showed more significant circulatory changes.
Area of Science:
- Anesthesiology
- Cardiovascular Physiology
- Thoracic Surgery
Background:
- Thoracic surgery requires careful hemodynamic management, especially during one-lung ventilation (OLV).
- Anesthetic choices significantly impact cardiopulmonary function during these procedures.
Purpose of the Study:
- To compare the effects of two anesthetic regimens on hemodynamic parameters during thoracic surgery.
- To evaluate gas exchange, metabolic rate, and blood flow characteristics under different anesthesia protocols.
Main Methods:
- Comparative analysis of ketamine-fentanyl-pipecuronium versus propofol-fentanyl-pipecuronium anesthesia.
- Invasive hemodynamic monitoring using PiCCOplus (transpulmonary thermodilution - TT) and VoLEF (pulmonary thermodilution - PT).
- Assessment during a ventilation mode change from asynchronous lung ventilation (ALV) to OLV and back to ALV, with OLV exceeding 1.5 hours.
Main Results:
- Propofol-based anesthesia demonstrated superior maintenance of hemodynamic stability compared to ketamine-based anesthesia.
- Significant alterations in pressor, resistive, and volumetric characteristics of pulmonary blood flow were observed with ketamine.
- Metabolic rate and gas exchange showed less variability under propofol anesthesia.
Conclusions:
- Propofol-fentanyl-pipecuronium anesthesia is associated with better hemodynamic management during prolonged OLV in thoracic surgery.
- Ketamine-fentanyl-pipecuronium anesthesia may lead to more pronounced cardiovascular disturbances.
- Optimizing anesthetic strategy is crucial for improving patient outcomes in thoracic surgery.
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