Reid C W, Slinger P D, Lenis S
Department of Anesthesia, University of Toronto, Ontario, Canada.
J Cardiothorac Vasc Anesth. 1996 Dec;10(7):860-3. doi: 10.1016/s1053-0770(96)80046-2.
To determine whether intravenous propofol-alfentanil anesthesia provides superior arterial oxygenation (Pao2) during one-lung ventilation (OLV) compared with isoflurane inhalation anesthesia.
A prospective, randomized, cross-over study.
Tertiary-care university hospital.
Thirty adults having either thoracoscopic pulmonary surgery or esophageal surgery.
Patients received either propofol-alfentanil infusion anesthesia or one minimum alveolar concentration (MAC) of isoflurane during the initial period of two-lung ventilation and the first 30 minutes of OLV and then were switched to the other anesthetic for the duration of OLV.
Arterial blood gases and hemodynamics were recorded during two-lung ventilation and after 20 and 30 minutes of OLV with each anesthetic technique. The mean values (+/- SD) for Pao2 during propofol-alfentanil anesthesia after 20 minutes (222 +/- 100) and 30 minutes (228 +/- 102 mmHg) of one-lung ventilation were not significantly different than after 20 minutes (213 +/- 99) or 30 minutes (214 +/- 96 mmHg) of isoflurane; beta error less than 0.1. Mean heart rate was lower during intravenous (78 +/- 15 min) than inhalation (85 +/- 17 min) anesthesia (rho = 0.03).
This study does not support the theory that total intravenous anesthesia will decrease the risk of hypoxemia during OLV.
确定与异氟烷吸入麻醉相比，静脉注射丙泊酚-阿芬太尼麻醉在单肺通气（OLV）期间是否能提供更好的动脉氧合（Pao2）。
一项前瞻性、随机、交叉研究。
三级大学教学医院。
30名接受胸腔镜肺手术或食管手术的成年人。
患者在双肺通气初期和OLV的前30分钟接受丙泊酚-阿芬太尼输注麻醉或一个最低肺泡浓度（MAC）的异氟烷，然后在OLV期间改用另一种麻醉剂。
在双肺通气期间以及每种麻醉技术进行OLV 20分钟和30分钟后记录动脉血气和血流动力学。丙泊酚-阿芬太尼麻醉下单肺通气20分钟（222±100）和30分钟（228±102 mmHg）时Pao2的平均值与异氟烷麻醉20分钟（213±99）或30分钟（214±96 mmHg）时相比无显著差异；Ⅱ类错误小于0.1。静脉麻醉期间平均心率（78±15次/分钟）低于吸入麻醉（85±17次/分钟）（ρ=0.03）。
本研究不支持全静脉麻醉会降低OLV期间低氧血症风险这一理论。
