Intravenous versus inhalation anaesthesia for one-lung ventilation

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• One-lung ventilation (OLV) is a critical technique in thoracic surgery and intensive care.
• Anesthesia for OLV can be maintained with intravenous or inhalation agents.
• The choice of anesthetic may impact patient outcomes, potentially affecting hypoxic pulmonary vasoconstriction (HPV).

Purpose of the Study:

• To evaluate the effectiveness and safety of intravenous versus inhalation anesthesia for one-lung ventilation.
• To synthesize evidence from randomized and quasi-randomized controlled trials.

Main Methods:

• Comprehensive literature search across multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS, Web of Science) up to November 2012.
• Inclusion of randomized and quasi-randomized controlled trials comparing intravenous and inhalation anesthesia for OLV.
• Independent assessment of trial quality and data extraction by two reviewers.

Main Results:

• Twenty studies with 850 surgical participants were included; no studies focused on non-surgical OLV.
• No evidence demonstrated a difference in participant outcomes based on the anesthetic maintenance method.
• Methodological quality of included studies was often poorly reported, leading to unclear bias classification.

Conclusions:

• Limited evidence from randomized controlled trials suggests no significant difference in outcomes between intravenous and inhalational anesthesia during OLV.
• Future research should prioritize well-designed randomized controlled trials with robust outcome measures, rather than focusing solely on physiological variables.