RESUMO
The effect of anesthetics on hemodynamic variables (HV) has been clarified, but ambiguity existed concerning their effect on oxygenation variables (OV). Radical cystectomy provided a clinical setting for studying the effect of anesthetics on perioperative HV and OV. Patients subjected to radical cystectomy (n = 33) were assigned through balanced randomization to receive one of four anesthetic modalities, namely; group I: inhalation anesthesia using N2O:O2, halothane, d-tubocurarine (n = 11); group II: inhalation anesthesia using N2O:O2, halothane, d-tubocurarine, and supplemented with epidural analgesia (EA) (n = 11); group III: total intravenous anesthesia (TIVA) using ketamine 10-30 ug.kg-1.min-1, propofol 2 mg.kg-1.h-1, d-tubocurarine, and supplemented with continuous EA (n = 6): and group IV:TIVA using ketamine 20-50 ug.kg-1.min-1, midazolam in increments of 1.5 to 5 mg, and supplemented with intermittent EA (n = 5). Monitoring entailed continuous ECG, pulse oximerty, invasive arterial pressure, and pulmonary artery catheter for HV (HR, MAP, PAP, PAOP, CO, SVR, and PVR) and OV. (PaO2, SaO2, PvO2, SvO2, a-vDO2, O2ext, Qs/Qt, DO2, and VO2). The heart rate was lower in TIVA while other HV did not show striking differences, Group I showed higher arterial oxygen tension than group II and IV. Mixed venous oxygen tension and saturation were higher in group I over group IV. Other OV did not show remarkable differences. In conclusion, HV and OV in 4 anesthetic modalities did not elicit striking differences.
