title: The possible influence of pulmonary arterio-venous shunt and hypoxic pulmonary vasoconstriction on arterial sevoflurane concentration during one-lung ventilation.
abstract: Sevoflurane is widely used for its rapid onset and offset due to a lower blood/gas coefficient. However, involuntary movements, tachycardia, and hypertension have been observed in some patients despite a continuing constantly delivered concentration of sevoflurane during 1-lung ventilation (OLV), indicating the possibility of insufficient depth of anesthesia. We observed a temporary but obvious decrease in arterial sevoflurane concentration and pulse oximeter readings in a patient during OLV. This may have resulted in the depth of inhaled anesthesia being insufficient during OLV because the arterial sevoflurane concentration was lower than expected in spite of constantly delivered and inspiratory/expiratory sevoflurane concentrations.
authors.affiliation: Department of Anesthesia, Kasukabe-chuo General Hospital, Midori-cho 5-9-4, Kasukabe, Saitama 344-0063, Japan. shinjimat@hotmail.com
authors.forename: Shinji
authors.initials: S
authors.lastname: Matsuse
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hara
authors.forename: Takako
authors.initials: T
authors.lastname: Ohkura
mesh_terms: D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D058926:Intraoperative Awareness / Q000517:prevention & control; D008168:Lung / Q000098:blood supply*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010092:Oximetry; D011651:Pulmonary Artery / Q000503:physiopathology*; D011652:Pulmonary Circulation / Q000187:drug effects; D011667:Pulmonary Veins / Q000503:physiopathology*; D012121:Respiration, Artificial / Q000009:adverse effects*; D000077149:Sevoflurane; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane