Clinical trial NCT02191371: Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation
Official title: Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mechanical Ventilation Complication
Keywords: oxygenation
microcirculation
one-lung ventilation
thoracic surgery
Lead sponsor: Seoul National University Hospital
Sponsor class: OTHER
First posted: 2014-07-16
Enrollment: 104
Sex: ALL
Minimum age (years): 20
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

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.

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

Primary outcomes:
measure: arterial partial pressure of oxygen
timeFrame: 30 min after one-lung ventilation
Secondary outcomes:
measure: recovery slope
timeFrame: 30 min after one-lung ventilation
Other outcomes:
measure: blood pressure
timeFrame: 30 min after one-lung ventilation
Locations:
city: Seoul
country: Korea, Republic of
facility: Seoul National University Hospital
Study officials:
affiliation: Seoul National University Hospital
name: Yunseok Jeon, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Cho YJ, Kim TK, Hong DM, Seo JH, Bahk JH, Jeon Y. Effect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trial. BMC Anesthesiol. 2017 Jan 18;17(1):9. doi: 10.1186/s12871-017-0302-x.