Effects of thoracic epidural meperidine on arterial oxygenation during one-lung ventilation in thoracic surgery.
OBJECTIVE
To compare the effects that the use of general intravenous anesthesia (propofol-fentanyl) (GA) or general anesthesia combined with thoracic epidural anesthesia with meperidine (TEA-M) may have on arterial oxygenation during one-lung ventilation (OLV).


METHODS
Prospective.


METHODS
Tertiary care hospital.


METHODS
Seventy-two patients undergoing OLV for thoracic surgery.


METHODS
Patients were prospectively randomized into two groups: GA (n = 37) fentanyl, propofol, rocuronium anesthesia was used; and group TEA-M (n = 35) were anesthetized with propofol, rocuronium and thoracic epidural meperidine (2 mg/kg in 10-12 mL) administered before anesthetic induction. A double-lumen endotracheal tube was inserted, and mechanical ventilation with 100% oxygen was used during study. Mean arterial pressure, heart rate and arterial and venous blood gases were recorded with the patients in the lateral decubitus position in three phases: during two-lung ventilation (TLV), 15 and 30 minutes after beginning OLV (OLV + 15 and OLV + 30 respectively). The authors measured arterial and venous central oxygen tension, arterial and venous central oxygen saturation, arterial and venous central oxygen content and venous admixture percentage (Qs/Qt%).


RESULTS
There were no statistical differences between the two groups for PaO(2) during OLV + 15 (GA = 165 mmHg, TEA-M = 153 mmHg) and OLV + 30 (GA = 176 mmHg, TEA-M = 158 mmHg); and with values for Qs/Qt%.


CONCLUSIONS
It is concluded that GA combined with TEA-M (2 mg/kg) do not affect arterial oxygenation during OLV in thoracic surgery.
Garutti
Ignacio
I
Department of Anesthesiology and Reanimation, Hospital General, "Gregorio Marañon", Madrid, Spain. ngarutti@inicia.es
Cruz
Patricia
P
Olmedilla
Luis
L
Barrio
Jose María
JM
Cruz
Alberto
A
Fernandez
Carmen
C
Perez-Peña
Jose M
JM
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D001158:Arteries / Q000378:metabolism; D001784:Blood Gas Analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy; D008168:Lung / Q000098:blood supply* / Q000378:metabolism / Q000601:surgery*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D008614:Meperidine; D010100:Oxygen; D005283:Fentanyl