الفهرس | Only 14 pages are availabe for public view |
Abstract One lung ventilation (OLV) is required for several thoracic operations; adequate arterial oxygenation is not achieved in some patients despite an accurately placed endobronchial tube, due to, in part, to inhibition of hypoxic pulmonary vasoconstriction (HPV). HPV is an important mechanism by which blood is diverted from the hypoxic region of the lung to a better-ventilated region, thereby reducing the venous admixture and minimizing the decrease in arterial oxygenation. Intravenous anesthetic agents including propofol have not been shown to inhibit hypoxic pulmonary vasoconstriction. This might encourage the use of propofol in thoracic surgery where one lung ventilation is required. Sevoflurane has useful effects during thoracic surgery. It is a potent bronchodilator and its low blood-gas partition coefficient allow rapid adjustment of the depth of anesthesia. Rapid emergence from anesthesia allows rapid return of spontaneous respiration and avoid the risk of postoperative mechanical ventilation. The present study compared the effect of both total intravenous anesthesia using propofol infusion and inhalational anesthesia using sevoflurane on pulmonary shunt fraction and hemodynamic variables in patients requiring one lung ventilation during thoracic surgery. Twenty patients were studied, aged 20-65 years and ASA physical status I, II and III they were scheduled for lobectomy with one-lung ventilation, and were randomly assigned into two groups. Group I: patients were anesthetized using intravenous anesthesia using propofol. Group II: patients were anesthetized with inhalation anesthesia using sevoflurane. |