Yamada Naoto, Nagata Hirofumi, Sato Yoshiharu, Tomoyasu Makoto
Department of Anesthesiology, Iwate Medical University, Morioka.
Masui. 2008 Nov;57(11):1388-97.
The present study was designed to evaluate the alteration of cerebral regional oxygen saturation (rSO2) associated with propofol or sevoflurane during one-lung ventilation (OLV).
Fifty patients scheduled for a lung lobectomy were randomly assigned to propofol or sevoflurane group. General anesthesia was maintained with propofol (target controlled infusion; 2-3 mcg x ml(-1)) in propofol group (n=25), and sevoflurane (end-tidal concentration 1-2%) in sevoflurane group (n=25), being adjusted to maintain BIS values between 40 and 60. BIS and rSO2 values were continuously monitored. Arterial blood gas analysis was performed as follows: during two-lung ventilation before OLV (baseline), during the first 120 minutes of OLV and at the end of OLV and surgery.
During OLV rSO2 was significantly lower than baseline in both groups. The values of rSO2 were not significantly different between the groups at each time. We could not find accurate correlation between rSO2 and other factors monitored.
We conclude OLV leads to the decrease of rSO2, but there is no difference in the alteration of rSO2 between propofol and sevoflurane group. To maintain adequate rSO2, we should consider together in combination with respiratory, circulatory or metabolic index and depth of anesthesia.
本研究旨在评估单肺通气（OLV）期间丙泊酚或七氟醚对脑局部氧饱和度（rSO2）的影响。
50例计划行肺叶切除术的患者被随机分为丙泊酚组或七氟醚组。丙泊酚组（n = 25）采用丙泊酚靶控输注维持全身麻醉（靶浓度2 - 3 mcg·ml⁻¹），七氟醚组（n = 25）采用七氟醚维持全身麻醉（呼气末浓度1 - 2%），调整麻醉深度使脑电双频指数（BIS）值维持在40至60之间。持续监测BIS和rSO2值。动脉血气分析在以下时段进行：OLV前双肺通气时（基线）、OLV的前120分钟、OLV结束时及手术结束时。
OLV期间两组rSO2均显著低于基线值。各时段两组间rSO2值差异无统计学意义。未发现rSO2与其他监测因素之间存在确切相关性。
我们得出结论，OLV导致rSO2降低，但丙泊酚组和七氟醚组rSO2的变化无差异。为维持足够的rSO2，应综合考虑呼吸、循环或代谢指标及麻醉深度。
