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Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation

Not Applicable
Completed
Conditions
Mechanical Ventilation Complication
Interventions
Registration Number
NCT02191371
Lead Sponsor
Seoul National University Hospital
Brief Summary

One-lung ventilation during thoracic surgery may affect systemic oxygenation and peripheral microcirculation by hypoxic pulmonary vasoconstriction. Both intravenous and inhalational anesthetics can be used during one-lung ventilation. However, there is still a controversy which anesthetic would be more appropriate during one-lung ventilation in the perspective of oxygenation and microcirculation. The investigators hypothesized that intravenous and inhalational anesthetics may affect oxygenation and microcirculation differently during one-lung ventilation.

Detailed Description

Patients undergoing thoracic surgery including one-lung ventilation will be randomized to receive intravenous (propofol) or inhalational (desflurane) anesthetic.

Systemic oxygenation can be evaluated by measuring partial pressure of oxygen in arterial blood analysis. Microcirculatory parameters can be obtained from vascular occlusion test. Among those parameters, recovery slope during vascular occlusion test is known to reflect recruitment of microvasculature in response to hypoxic or ischemic insult. In this study, we will compare arterial partial pressure of oxygen and recovery slope during one-lung ventilation between propofol and desflurane group.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
104
Inclusion Criteria
  • undergoing thoracic surgery including one-lung ventilation
Exclusion Criteria
  • refuse to enroll
  • BMI over 30 kg/m(2)
  • severe obstructive or restrictive lung disease
  • preoperative supplemental oxygen, intubated, or mechanical ventilatory support
  • preoperative arterial partial pressure of oxygen < 60 mmHg
  • pregnancy
  • history of coronary artery disease
  • preoperative continuous infusion of vasopressor or inotropes
  • cannot undergo vascular occlusion test: anatomical abnormality of both arms, severe peripheral vascular disease, presence of A-V fistula

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
propofolpropofolPropofol is used as a maintenance anesthetic to patients in the propofol group. Intervention: propofol infusion by target-controlled infusion for maintaining anesthesia propofol (Fresofol MCT 2%) target effect site concentration: 4\~5 mcg/ml, during general anesthesia
desfluranedesfluraneDesflurane is used as a maintenance anesthetic to patients in the desflurane group. Intervention: Desflurane administration for maintaining anesthesia desflurane (Suprane) inhalation as 6\~8 vol% during general anesthesia
Primary Outcome Measures
NameTimeMethod
arterial partial pressure of oxygen30 min after one-lung ventilation

Primary outcome is arterial partial pressure of oxygen 30 min after one-lung ventilation during thoracic surgery in propofol and desflurane groups.

Secondary Outcome Measures
NameTimeMethod
recovery slope30 min after one-lung ventilation

Secondary outcome is recovery slope measured by vascular occlusion test 30 min after one-lung ventilation during thoracic surgery in propofol and desflurane groups.

Trial Locations

Locations (1)

Seoul National University Hospital

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Seoul, Korea, Republic of

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