Effect of Thoracic Epidural Anesthesia on Oxygen Saturation During one-lung Ventilation in Pulmonary Resection Surgery

Document Type : Research Paper

Authors

1 Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran

2 Assistant Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran

3 Instructor of Anesthesiology,Tabriz University of Para Medical Sciences,Tabriz ,Iran

4 Student of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

5 Anesthesiologyst, Tabriz, Iran

6 Resident of anesthesiology, Tabriz, Iran

Abstract

Introduction
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.
Materials and Methods
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 .
Results
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.
Conclusion
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.

Keywords

References

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medical journal of mashhad university of medical sciences
Volume 54, Issue 3 - Serial Number 3
September and October 2010
Pages 150-158

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