Division of Surgical Center, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima, 770-8503, Japan.
Department of Anesthesiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
BMC Anesthesiol. 2022 Apr 29;22(1):125. doi: 10.1186/s12871-022-01669-7.
This study evaluated whether desflurane improved lung collapse during one-lung ventilation (OLV) more than propofol, and whether it could reduce the operation time of video-assisted thoracic surgery.
Sixty patients undergoing lobectomy by video-assisted thoracic surgery (VATS) were randomly assigned to general anesthesia with desflurane or propofol. Lungs were inspected by thoracoscope at 10, 30, and 60 min after initiation of OLV. After surgery, the Lung Collapse Score, a composite of lung color and volume assessments, was assigned by two clinicians blinded to the anesthetic regimen. The primary outcome was operation time. The secondary outcome included the complication rate.
Of the 60 participants, 50 completed the study, 26 in Desflurane group and 24 in Propofol group. The Lung Collapse Scores at 30 and 60 min after OLV initiation were significantly better in Desflurane group than in Propofol group, and operation time was significantly shorter in Desflurane group (214 (57) min vs. 262 (72) min [mean (SD)], difference in means, -48; 95% CI, -85 to -11; P = 0.01). The incidence of multiple complications was 1/26 (3%) and 6/24 (25%) in Desflurane and Propofol group, respectively (relative risk, 0.1; 95% CI, 0.02 to 1.18; P = 0.04).
Desflurane improved lung collapse during OLV and significantly shortened VATS lobectomy operation time compared to propofol in our studied patients. Desflurane resulted in fewer postoperative complications. Thus, desflurane may be an appropriate anesthetic during lobectomy by VATS requiring OLV.
The study was registered with the University Hospital Medical Information Network ( UMIN000009412 ). The date of disclosure of this study information is 27/11/2012. On this date, we registered the study into UMIN; patients were included from 2013 to 2014. However, on 11/27/2015, the UMIN system administrator suggested a detailed description. Thereafter, we added it to the Randomization Unit. Despite being prospective, it was retrospectively registered on UMIN for the above reasons.
本研究评估了地氟烷是否比丙泊酚更能改善单肺通气（OLV）期间的肺萎陷，并评估其是否能缩短电视辅助胸腔镜手术（VATS）的手术时间。
60 例行 VATS 肺叶切除术的患者被随机分为地氟烷或丙泊酚全身麻醉组。OLV 开始后 10、30 和 60 分钟时，通过胸腔镜检查肺部。术后，由两名不了解麻醉方案的临床医生对肺萎陷评分（一种综合肺颜色和体积评估的评分）进行赋值。主要结局是手术时间。次要结局包括并发症发生率。
60 名参与者中，50 名完成了研究，地氟烷组 26 名，丙泊酚组 24 名。OLV 开始后 30 分钟和 60 分钟时，地氟烷组的肺萎陷评分明显优于丙泊酚组，地氟烷组的手术时间明显缩短（214（57）分钟比 262（72）分钟[均值（标准差）]，差异均值为-48；95%置信区间，-85 至-11；P=0.01）。地氟烷组的并发症发生率为 1/26（3%），丙泊酚组为 6/24（25%）（相对风险，0.1；95%置信区间，0.02 至 1.18；P=0.04）。
与丙泊酚相比，地氟烷在我们研究的患者中改善了 OLV 期间的肺萎陷，并显著缩短了 VATS 肺叶切除术的手术时间。地氟烷术后并发症较少。因此，地氟烷可能是 OLV 期间需要 VATS 肺叶切除术的合适麻醉药物。
该研究在大学医院医疗信息网络（UMIN000009412）进行了注册。本研究信息披露日期为 2012 年 11 月 27 日。在这一天，我们将该研究注册到 UMIN；患者纳入时间为 2013 年至 2014 年。然而，在 2015 年 11 月 27 日，UMIN 系统管理员建议详细描述。此后，我们在随机分组单元中添加了该描述。尽管是前瞻性的，但由于上述原因，它被回溯性地注册到 UMIN。
