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Effect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trial

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dc.contributor.authorCho, Youn Joung-
dc.contributor.authorKim, Tae Kyong-
dc.contributor.authorHong, Deok Man-
dc.contributor.authorSeo, Jeong-Hwa-
dc.contributor.authorBahk, Jae-Hyon-
dc.contributor.authorJeon, Yunseok-
dc.date.accessioned2017-02-02T02:38:13Z-
dc.date.available2017-02-02T02:38:13Z-
dc.date.issued2017-01-18-
dc.identifier.citationBMC Anesthesiology, 17(1):9ko_KR
dc.identifier.urihttps://hdl.handle.net/10371/100385-
dc.descriptionThis article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
ko_KR
dc.description.abstractAbstract

Background
One-lung ventilation during thoracic surgery frequently disturbs normal systemic oxygenation. However, the effect of anesthetics on arterial oxygenation during one-lung ventilation has not been well established in human study. In this clinical trial, we investigated whether a difference between desflurane-remifentanil and propofol-remifentanil anesthesia can be observed with regard to oxygenation during one-lung ventilation for thoracoscopic surgery.


Methods
Adult patients with lung cancer, scheduled for video-assisted thoracoscopic lobectomy without preoperative oxygen support, were screened and randomized to receive desflurane or propofol, with remifentanil continuous infusion in both groups. Mechanical ventilation was performed with tidal volume of 8 ml/kg and FIO2 0.5 during two-lung ventilation, and 6 ml/kg and 1.0 during one-lung ventilation, both with positive end-expiratory pressure of 5 cmH2O. Arterial blood gas analysis was performed preoperatively, during two-lung ventilation, and after 15, 30, 45, and 60 min of one-lung ventilation. The primary endpoint was PaO2 at 30 min after initiating one-lung ventilation. Statistical analyses included the independent t-test for the primary endpoint and a mixed model with a post-hoc analysis to evaluate the serial changes in values.


Results
Patients were recruited between July 9 and December 2, 2014. In total, 103 patients were analyzed (n = 52 in desflurane group and n = 51 in propofol group). The primary endpoint, PaO2 at 30 min of one-lung ventilation was lower in the desflurane group than the propofol group (170 ± 72 vs. 202 ± 82 mmHg; p = 0.039). Serial changes in PaO2 during one-lung ventilation showed lower levels during desflurane anesthesia compared with propofol anesthesia (mean difference, 45 mmHg; 95% confidence interval, 16–75 mmHg; p = 0.003).


Conclusions
In conclusion, desflurane-remifentanil anesthesia resulted in decreased arterial oxygenation compared with that of propofol-remifentanil anesthesia during one-lung ventilation for thoracoscopic surgery in patients with lung cancer.


Trial registration
ClinicalTrials.gov identifier:
NCT02191371

, registered on July 7, 2014
ko_KR
dc.language.isoenko_KR
dc.publisherBioMed Centralko_KR
dc.subjectDesfluraneko_KR
dc.subjectPropofolko_KR
dc.subjectOne-lung ventilationko_KR
dc.subjectOxygenationko_KR
dc.titleEffect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trialko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor조윤정-
dc.contributor.AlternativeAuthor김태경-
dc.contributor.AlternativeAuthor홍덕만-
dc.contributor.AlternativeAuthor서정화-
dc.contributor.AlternativeAuthor박재현-
dc.contributor.AlternativeAuthor전윤석-
dc.identifier.doi10.1186/s12871-017-0302-x-
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2017-01-22T03:04:11Z-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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