The effect of thoracic epidural anesthesia on pulmonary shunt fraction and arterial oxygenation during one-lung ventilation

Journal of Cardiothoracic and Vascular Anesthesia
Sung Mee JungJeong Min Park

Abstract

To compare the effect of thoracic epidural local anesthetic, epidural opioid, and intravenous opioid on pulmonary shunt fraction, arterial oxygenation, and hemodynamic changes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. A prospective, randomized, double-blind study. A university hospital. Thirty-nine patients undergoing OLV for pulmonary resection. Patients were randomized into 1 of 3 groups: epidural bupivacaine (TEA-B group, n = 13), epidural sufentanil (TEA-S group, n = 13), or intravenous remifentanil (IV-R group, n = 13) during general anesthesia with propofol. A double-lumen tube was inserted, and mechanical ventilation with 100% oxygen was used in the lateral decubitus position. Hemodynamic variables and arterial and mixed venous blood gas analysis from the radial and pulmonary artery catheter were measured and shunt fraction was calculated during two-lung ventilation (TLV), 15, 30, and 60 minutes after the initiation of OLV, and 15 minutes after the reinstitution of TLV. Although mean arterial pressures 15 and 30 minutes after OLV in the IV-R group were significantly higher than the value in TEA-S group, cardiac output and pulmonary vascular resistance were maintained. Decreases in PaO(2),...Continue Reading

References

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Nov 27, 2008·Anesthesiology·Martin Neukirchen, Peter Kienbaum

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Citations

May 18, 2011·British Journal of Anaesthesia·A Ng, J Swanevelder
Dec 2, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Camila Ferreira LeiteRicardo Kalaf Mussi
Nov 19, 2010·Current Opinion in Anaesthesiology·Seiji Ishikawa, Jens Lohser
Feb 16, 2011·Current Opinion in Anaesthesiology

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