[Effect of thoracic epidural anesthesia on oxygen saturation during one-lung ventilation in pulmonary resection surgery]

ABSTRACT

The perfusion in the nonventilated, operative lung during one-lung ventilation [OLV] in patients undergoing thoracic surgery increases intrapulmonary shunt and decreases systemic arterial oxygenation. The anesthesia with OLV may affect oxygenation. The aim of this study was comparing the effect of total intravenous anesthesia [TIVA] and thoracic epidural anesthesia [TEA] combined with TIVA on saturation of oxygen during OLV in patients undergoing pulmonary resection. In a randomized double-blind clinical trial, 60 patients undergoing elective pulmonary resection were Divided in to two groups. The intervention group received TEA [bupivacaine 0.25%] plus TIVA [propofol+remifentanil] while the control group received TEA [saline] plus TIVA.The hemodynamic parameters, Aldrete score and possible complications were compared between the two groups, within the study period. The change of hemodynamic parameters, as well as SaO2, PaO2 and ETCO2 within the study period was not significantly different between the two groups. The mean Aldrete score was comparable between the two groups upon entering recovery and after getting discharged from there. During the recovery stay, frequency of patients with pain and shivering was significantly higher in the group with sole TIVA. There was no significant difference in nausea and hypotension between the two groups. TEA plus TIVA does not have a significant effect on O2 saturation in OLV in patients comparing with sole TIVA. However, this combination significantly decreases the post-operative pain and shivering and so may be recommended