Department of Anesthesiology and Intensive Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Cir Cir. 2022;90(S1):52-60. doi: 10.24875/CIRU.21000440.
One-lung ventilation may cause negative changes in the oxygenation of cerebral tissue which results in post-operative cognitive dysfunction. We compared the potential effects of total intravenous anesthesia and inhalation general anesthesia techniques on cerebral tissue oxygenation.
In this prospective double-blind trial, patients whose standard anesthesia induction was done were randomly divided into two groups as group total intravenous anesthesia using propofol (Group T, n = 30) and group inhalation general anesthesia using sevoflurane (Group I, n = 30) based on anesthesia maintenance. The intraoperative cerebral oxygen saturation and pre-post-operative mini-mental status test scores of the patients were monitored and recorded.
Baseline characteristics were similar between the two groups. The decrease of cerebral oxygen saturation more than 20% in total intravenous anesthesia group was significantly higher than inhalation group (p < 0.05). In both groups, the mini-mental status test values at the post-operative 3 h were significantly lower than the pre-operative and post-operative 24 h values (p < 0.05).
Inhalation general anesthesia provided better cerebral tissue oxygenation in thoracic surgery with one-lung ventilation compared to total intravenous anesthesia. However, there was no significant correlation between the presence of desaturation and post-operative cognitive dysfunction.
单肺通气可能会导致脑组织的氧合发生负面变化，从而导致术后认知功能障碍。我们比较了全凭静脉麻醉和吸入全身麻醉技术对脑组织氧合的潜在影响。
在这项前瞻性双盲试验中，根据麻醉维持情况，将标准麻醉诱导完成的患者随机分为两组：使用丙泊酚的全凭静脉麻醉组（T 组，n = 30）和使用七氟醚的吸入全身麻醉组（I 组，n = 30）。监测并记录患者术中脑氧饱和度和术前、术后简易精神状态检查评分。
两组患者的基线特征相似。全凭静脉麻醉组的脑氧饱和度下降超过 20%的比例明显高于吸入组（p < 0.05）。在两组中，术后 3 小时的简易精神状态检查值均明显低于术前和术后 24 小时的值（p < 0.05）。
与全凭静脉麻醉相比，在单肺通气的胸腔手术中，吸入全身麻醉可提供更好的脑组织氧合。然而，饱和度下降与术后认知功能障碍之间没有显著相关性。
