Halothane and isoflurane only slightly impair arterial oxygenation during one-lung ventilation in patients undergoing thoracotomy.
Controversy exists as to whether the halogenated inhalation (IH) anesthetics impair arterial oxygenation during one-lung ventilation (1-LV). Accordingly, the authors have answered this question in 12 consenting patients who required 1-LV to facilitate the performance of thoracic surgery, by comparing arterial oxygenation during a prolonged period of IH anesthesia with arterial oxygenation during a prolonged period of intravenous (IV) anesthesia during stable 1-LV conditions. The patients were equally divided into halothane and isoflurane groups. Each patient in each IH anesthetic group underwent the following experimental sequence: step 1, two-lung ventilation (2-LV), 1 MAC IH anesthesia; step 2, 1-LV, 1 MAC IH anesthesia; step 3, 1-LV, iv anesthesia; step 4, 2-LV, iv anesthesia. Stable 1-LV conditions were proven by serial arterial blood gas measurement. Conversion from 2-LV to 1-LV during IH anesthesia (step 1 to step 2) caused a very large and significant decrease in PaO2 (from 484 +/- 49 to 116 +/- 61, and from 442 +/- 58 to 232 +/- 97 mmHg in the halothane and isoflurane groups, respectively) and increase in shunt (from 14 +/- 4 to 44 +/- 9, and from 19 +/- 5 to 31 +/- 8% in the halothane and isoflurane groups, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Benumof
J L
JL
Department of Anesthesia, University of California, San Diego, La Jolla 92093.
Augustine
S D
SD
Gibbons
J A
JA
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001158:Arteries; D006221:Halothane / Q000009:adverse effects*; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D012121:Respiration, Artificial; D013908:Thoracotomy
D007530:Isoflurane; D010100:Oxygen; D006221:Halothane