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Epidural block does not worsen oxygenation during one-lung ventilation for lung resections under isoflurane/nitrous oxide anaesthesia

Published online by Cambridge University Press:  11 May 2005

A. Casati ,
G. Mascotto ,
K. Iemi ,
J. Nzepa-Batonga  and
M. De Luca
A. Casati
Affiliation:
University of Parma, Department of Anaesthesiology and Pain Therapy, Parma, Italy
G. Mascotto
Affiliation:
Azienda Ospedaliera di Pietraligure, Department of Anaesthesiology, Pietraligure, Italy
K. Iemi
Affiliation:
Vita Salute University of Milan, Department of Anaesthesiology, Milano, Italy
J. Nzepa-Batonga
Affiliation:
Vita Salute University of Milan, Department of Anaesthesiology, Milano, Italy
M. De Luca
Affiliation:
Vita Salute University of Milan, Department of Anaesthesiology, Milano, Italy
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Extract

Summary

Background and objectives: The aim of this prospective, randomized, controlled clinical study was to evaluate the effects of thoracic epidural anaesthesia combined with isoflurane/nitrous oxide anaesthesia on intraoperative oxygenation during one-lung ventilation for lung resections.

Methods: Forty patients were randomly allocated to receive general anaesthesia maintained with isoflurane/nitrous oxide (group General, n = 20) or the same anaesthetic combined with thoracic epidural anaesthesia (group Integrated, n = 20). All patients were mechanically ventilated with the same settings (FiO2 = 0.5; VT = 9 mL kg−1; inspiratory : expiratory time = 1 : 1; inspiratory pause = 10%). Effects on oxygenation were evaluated by determining the changes in PaO2/FiO2 ratio at 10, 30, 45 and 60 min of one-lung ventilation as compared to values obtained after induction of anaesthesia (supine, two-lung ventilation).

Results: The PaO2/FiO2 ratio was decreased in both groups during one-lung ventilation until the end of surgery. No differences were found at any observation time between the groups. Ventilation with 100% oxygen because of SPO2 decrease <92% was required in nine patients of group General (45%) and in eight patients of group Integrated (40%) (P = 0.64). Manual re-inflation of the operated lung was required in one patient of group General only (P = 0.99). Heart rate was lower in group Integrated than in group General throughout the study. No differences between the two groups in mean arterial pressure were observed.

Conclusions: Adding a thoracic epidural block to isoflurane/nitrous oxide anaesthesia during one-lung ventilation for lung resections does not result in clinically relevant detrimental effects on intraoperative oxygenation.

Keywords

SURGERY, thoracicANAESTHESIA, general, epiduralMONITORING, oxygenation
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 5 , May 2005 , pp. 363 - 368
Copyright
© 2005 European Society of Anaesthesiology

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