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Arterial oxygenation during one lung ventilation

T Shimizu1, K Abe, K Kinouchi

  • 1Department of Anaesthesiology of Osaka University Medical School, Japan.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|December 17, 1997
PubMed
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Isoflurane and sevoflurane have similar effects on arterial oxygenation during one-lung ventilation (OLV). Both anesthetics maintained middle cerebral artery (MCA) blood flow velocity in patients undergoing thoracic surgery.

Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Neuroanesthesia

Background:

  • One-lung ventilation (OLV) is crucial for thoracic surgeries but can impact gas exchange and cerebral blood flow.
  • Isoflurane and sevoflurane are common volatile anesthetics used during OLV, with potential differential effects on physiological parameters.

Purpose of the Study:

  • To compare the impact of isoflurane versus sevoflurane on arterial oxygenation (PaO2).
  • To evaluate the effects of these anesthetics on middle cerebral artery (MCA) blood flow velocity during OLV.

Main Methods:

  • A randomized crossover study involving 20 patients undergoing thoracotomy for esophageal cancer.
  • Patients received both isoflurane and sevoflurane in a crossover design during OLV.
  • Arterial blood gases and MCA blood flow velocity (using Doppler ultrasound) were monitored.

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Main Results:

  • PaO2 decreased significantly after OLV initiation in both groups, with no significant difference between isoflurane and sevoflurane.
  • Middle cerebral artery blood flow velocity remained stable throughout OLV for both anesthetic agents.
  • No significant differences in oxygenation or MCA blood flow velocity were observed between the two anesthetic groups.

Conclusions:

  • The choice between isoflurane and sevoflurane does not impact arterial oxygenation during OLV.
  • Both isoflurane and sevoflurane effectively maintain middle cerebral artery blood flow velocity during one-lung ventilation.
  • Clinical selection of either agent for OLV is unlikely to affect cerebral hemodynamics or oxygenation.