title: Comparison of pulmonary morbidity using sevoflurane or propofol-remifentanil anesthesia in an Ivor Lewis operation.
abstract: OBJECTIVE
  An inhalation anesthetic-induced attenuation effect on the inflammatory reaction during one-lung ventilation (OLV) has been reported. Pulmonary inflammation is a substantive prognostic factor for Ivor Lewis operations. Blood inflammatory parameters and postoperative pulmonary complications between sevoflurane and propofol-remifentanil anesthesia in patients undergoing Ivor Lewis operations were compared.
  
  
  METHODS
  A prospective, randomized study.
  
  
  METHODS
  A medical university.
  
  
  METHODS
  Forty-eight patients undergoing Ivor Lewis operation allocated randomly into 2 groups.
  
  
  METHODS
  Patients received sevoflurane or total intravenous anesthesia using propofol and remifentanil (n = 24 per group).
  
  
  RESULTS
  Blood interleukin-6 (IL-6), malondialdehyde (MDA), oxygenation, abnormalities on a chest radiograph (CXR), extubation, intensive care unit (ICU) stay, length of hospitalization, and postoperative complications were compared between the 2 anesthetic techniques. The level of IL-6 at the end of surgery was lower for sevoflurane (69.5 [35.9-121.0] pg/mL) than propofol-remifentanil (128.2 [92.8-163.8] pg/mL, p = 0.03), but this difference was not maintained 24 hours after surgery. Frequencies of abnormalities measured by a CXR, PaO(2)/F(I)O(2)<300, and PaCO(2) <50 mmHg until discharge, the postoperative highest C-reactive protein level, white blood cells, and MDA did not differ between the 2 anesthetics. No differences in the extubation time, ICU stay, discharge day, or the incidence of hospital complications between sevoflurane and propofol-remifentanil anesthesia techniques were observed.
  
  
  CONCLUSIONS
  Sevoflurane anesthesia attenuated an increase in blood IL-6 at the end of surgery but did not provide any advantages over propofol remifentanil in terms of postoperative pulmonary complications in Ivor Lewis operations.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Lee
authors.forename: Gun Hee
authors.initials: GH
authors.lastname: Kim
authors.forename: Jie Ae
authors.initials: JA
authors.lastname: Kim
authors.forename: Mikyoung
authors.initials: M
authors.lastname: Yang
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Ahn
authors.forename: Woo Seog
authors.initials: WS
authors.lastname: Sim
authors.forename: Ki Jeong
authors.initials: KJ
authors.lastname: Park
authors.forename: Byung Hui
authors.initials: BH
authors.lastname: Jun
mesh_terms: D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods; D004945:Esophagoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D009017:Morbidity; D010880:Piperidines / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol