Intravenous versus inhalation anaesthesia for one-lung ventilation

Módolo, Norma Sueli Pinheiro; Módolo, Marília Pinheiro; Marton, Marcos A.; Volpato, Enilze de Souza Nogueira; Arantes, Vinicius Monteiro; Nascimento, Paulo do; Dib, Regina El

doi:10.1002/14651858.cd006313.pub3

Cited by 42 publications

(27 citation statements)

References 51 publications

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“…This may reflect the theoretical benefits of TIVA to the thoracic anaesthetist in terms of preservation of hypoxic pulmonary vasoconstriction, as well as the convenience of separating the provision of anaesthesia from airway maintenance and lung isolation . Although a 2013 Cochrane review concluded “ that no evidence indicated that the drug used to maintain anaesthesia during one‐lung ventilation affected participant outcomes ” there is a significant body of randomised controlled trial data suggesting a reduced incidence of pulmonary inflammation and/or pulmonary complications in thoracic patients receiving volatile anaesthesia . This is perceived to stem from an immunomodulatory effect of volatile anaesthesia .…”

Section: Discussionmentioning

confidence: 99%

Association between anaesthetic technique and unplanned admission to intensive care after thoracic lung resection surgery: the second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit

et al. 2019

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Unplanned intensive care admission is a devastating complication of lung resection and is associated with significantly increased mortality. We carried out a two-year retrospective national multicentre cohort study to investigate the influence of anaesthetic and analgesic technique on the need for unplanned postoperative intensive care admission. All patients undergoing lung resection surgery in 16 thoracic surgical centres in the UK in the calendar years 2013 and 2014 were included. We defined critical care admission as the unplanned need for either tracheal intubation and mechanical ventilation or renal replacement therapy, and sought an association between mode of anaesthesia (total intravenous anaesthesia vs. volatile) and analgesic technique (epidural vs. paravertebral) and need for intensive care admission. A total of 253 out of 11,208 patients undergoing lung resection in the study period had an unplanned admission to intensive care in the postoperative period, giving an incidence of intensive care unit admission of 2.3% (95%CI 2.0-2.6%). Patients who had an unplanned admission to intensive care unit had a higher mortality (29.00% vs. 0.03%, p < 0.001), and hospital length of stay was increased (26 vs. 6 days, p < 0.001). Across univariate, complete case and multiple imputation (multivariate) models, there was a strong and significant effect of both anaesthetic and analgesic technique on the need for intensive care admission. Patients receiving total intravenous anaesthesia (OR 0.50 (95%CI 0.34-0.70)), and patients receiving epidural analgesia (OR 0.56 (95%CI 0.41-0.78)) were less likely to have an unplanned admission to intensive care after thoracic surgery. This large retrospective study suggests a significant effect of both anaesthetic and analgesic technique on outcome in patients undergoing lung resection. We must emphasise that the observed association does not directly imply causation, and suggest that well-conducted, large-scale randomised controlled trials are required to address these fundamental questions.

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Section: Discussionmentioning

confidence: 99%

Association between anaesthetic technique and unplanned admission to intensive care after thoracic lung resection surgery: the second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit

et al. 2019

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“…13 Alternatively, a recent review found little evidence for differences in outcomes between inhalation and intravenous anesthesia during lung surgery. 14 The purpose of this study was to compare the effect of sevoflurane vs propofol anesthesia on postoperative neurocognitive test scores and cerebral oxygenation parameters in a population of patients undergoing lung surgery. The primary outcome was defined as the incidence of POCD on postoperative day five.…”

Section: Résumémentioning

confidence: 99%

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

Egawa

Inoue

Nishiwada

et al. 2016

Can J Anesth/J Can Anesth

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“…In contrast to total intravenous anesthesia, the use of sevoflurane or desflurane inhalation anesthesic can inhibit the release of inflammatory mediators in local cells, reduce the role of inflammatory factors, thereby reducing the inflammation of the ventilation lung. Modolo [8] and others summed up 20 comparative studies about anesthesia and inhalation anesthesia for single lung ventilation,then achieved a meta-analysis that pointed out there is no strong evidence making sure that anesthetic drugs will affect the prognosis of patients. Dupont [9] also reported that the impact of sevoflurane and desflurane on hemodynamics in patients with pulmonary surgery had no statistically significant difference, but desflurane group woke up faster and earlier.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of sevoflurane and desflurane in the recovery of older patients undergoing thoracoscopic lobectomy

et al. 2017

BIO Web Conf.

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Abstract. Purpose :To compare various recovery quality of sevoflurane and desflurane in elderly patients underwent thoracoscopic lobectomy, and to provide a reliable basis for anesthesiologists to choose anesthesia maintaining drugs.Method :Sixty elderly patients undergoing thoracoscopic lobectomy were selected from October, 2015 to May, 2016, and were divided into two groups by random number table, namely, the group of Dofetilide (group D) 30 cases, and sevoflurane (group S) 30 cases.The time of spontaneous respiration, the time of eye opening, the time of extubation and the time of awakening were recorded respectively in two groups. The incidence of nausea, vomiting and restlessness were also recorded.Result:There is no statistical difference comparing data of two groups.The time of spontaneous respiration, the duration of spontaneous breathing, the time of conscious recovery, the time of extubation and the time of leaving the room were shorter in group D than in group S, the difference was statistically significant (P <0.05). (3) There were no significant differences in the incidence of adverse events between the two groups (P> 0.05).Conclusion :Compared with sevoflurane, desflurane can reduce the extubation and awakening time, improve the quality of awakening and speed up the turnover of surgery, and it has certain clinical application advantage for thoracoscopic lobectomy in elderly patients.

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Intravenous versus inhalation anaesthesia for one-lung ventilation

Cited by 42 publications

References 51 publications

Association between anaesthetic technique and unplanned admission to intensive care after thoracic lung resection surgery: the second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit

Association between anaesthetic technique and unplanned admission to intensive care after thoracic lung resection surgery: the second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

A comparative study of sevoflurane and desflurane in the recovery of older patients undergoing thoracoscopic lobectomy

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