Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation
Overview
- Phase
- Not Applicable
- Intervention
- propofol
- Conditions
- Mechanical Ventilation Complication
- Sponsor
- Seoul National University Hospital
- Enrollment
- 104
- Locations
- 1
- Primary Endpoint
- arterial partial pressure of oxygen
- Status
- Completed
- Last Updated
- 9 years ago
Overview
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.
Investigators
Eligibility Criteria
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
Arms & Interventions
propofol
Propofol 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
Intervention: propofol
desflurane
Desflurane 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
Intervention: desflurane
Outcomes
Primary Outcomes
arterial partial pressure of oxygen
Time Frame: 30 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 Outcomes
- recovery slope(30 min after one-lung ventilation)