The effect of hypercapnia and hypertension on cerebral oxygen balance during one-lung ventilation for lung surgery during propofol anesthesia.
OBJECTIVE
To investigate whether jugular bulb venous oxygen saturation (SjO(2)) values increased with induced hypercapnia or induced hypertension during propofol-based anesthesia for one-lung ventilation (OLV).


METHODS
Prospective clinical study.


METHODS
Operating room at University hospital.


METHODS
15 adult patients scheduled for elective thoracic procedures in the lateral position.


METHODS
General anesthesia was maintained with propofol combined with epidural anesthesia. During OLV, hypercapnia (PaCO(2) = 50 mmHg) and hypertension (20% increase in mean arterial pressure) were applied.


METHODS
SjO2 values were measured.


RESULTS
With hypercapnia, SjO(2) values increased 30 ± 18% (from 54.3 ± 8.8% to 69.3 ± 6.3%). With hypertension, SjO(2) values were increased by 9 ± 18% (from 54.4 ± 9.0% to 58.5 ± 8.8%). These changes were significantly different. No significant differences regarding SaO(2) were observed during OLV in the experimental period.


CONCLUSIONS
Hypercapnia, not hypertension, significantly improved cerebral oxygen balance without observed side effects during propofol anesthesia.
Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
Masato
M
Iwata
Satoki
S
Inoue
Masahiko
M
Kawaguchi
Michitaka
M
Kimura
Takashi
T
Tojo
Shigeki
S
Taniguchi
Hitoshi
H
Furuya
D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001921:Brain / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000378:metabolism*; D006973:Hypertension / Q000378:metabolism*; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D012121:Respiration, Artificial
D018686:Anesthetics, Intravenous; D010100:Oxygen; D015742:Propofol