Comparison of pulmonary morbidity using sevoflurane or propofol-remifentanil anesthesia in an Ivor Lewis operation.
J Cardiothorac Vasc Anesth
; 26(5): 857-62, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-22381051
ABSTRACT
OBJECTIVE:
An inhalation anesthetic-induced attenuation effect on the inflammatory reaction during one-lung ventilation (OLV) has been reported. Pulmonary inflammation is a substantive prognostic factor for Ivor Lewis operations. Blood inflammatory parameters and postoperative pulmonary complications between sevoflurane and propofol-remifentanil anesthesia in patients undergoing Ivor Lewis operations were compared.DESIGN:
A prospective, randomized study.SETTING:
A medical university.PARTICIPANTS:
Forty-eight patients undergoing Ivor Lewis operation allocated randomly into 2 groups.INTERVENTIONS:
Patients received sevoflurane or total intravenous anesthesia using propofol and remifentanil (n = 24 per group). MEASUREMENTS AND MAINRESULTS:
Blood interleukin-6 (IL-6), malondialdehyde (MDA), oxygenation, abnormalities on a chest radiograph (CXR), extubation, intensive care unit (ICU) stay, length of hospitalization, and postoperative complications were compared between the 2 anesthetic techniques. The level of IL-6 at the end of surgery was lower for sevoflurane (69.5 [35.9-121.0] pg/mL) than propofol-remifentanil (128.2 [92.8-163.8] pg/mL, p = 0.03), but this difference was not maintained 24 hours after surgery. Frequencies of abnormalities measured by a CXR, PaO(2)/F(I)O(2)<300, and PaCO(2) <50 mmHg until discharge, the postoperative highest C-reactive protein level, white blood cells, and MDA did not differ between the 2 anesthetics. No differences in the extubation time, ICU stay, discharge day, or the incidence of hospital complications between sevoflurane and propofol-remifentanil anesthesia techniques were observed.CONCLUSIONS:
Sevoflurane anesthesia attenuated an increase in blood IL-6 at the end of surgery but did not provide any advantages over propofol remifentanil in terms of postoperative pulmonary complications in Ivor Lewis operations.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Piperidinas
/
Complicações Pós-Operatórias
/
Propofol
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Esofagoscopia
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Pneumopatias
/
Éteres Metílicos
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article