title: Effects of volatile vs. propofol-based intravenous anesthetics on the alveolar inflammatory responses to one-lung ventilation: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The aim of this meta-analysis is to compare the potential effects of inhalation anesthetics with total intravenous anesthetics on alveolar cytokine expression and lung-related clinical outcomes in patients undergoing one-lung ventilation (OLV) for thoracic surgery.
  
  
  METHODS
  We retrieved the PubMed, EMBASE, and the Cochrane Library respectively to identify randomized controlled trials comparing different anesthetics (volatile anesthetics vs. intravenous anesthetics) on the pulmonary inflammatory response to OLV. The primary outcomes were the levels of alveolar concentrations of inflammatory cytokines.
  
  
  RESULTS
  Eight randomized controlled trials that included 365 patients were screened. Overall, there were significant differences in the concentration of alveolar inflammatory mediators between volatile group and intravenous group, in which volatile group had lower levels of TNF-α (SMD -1.51; 95 % CI -2.15 to -0.87; p < 0.001), IL-6 (SMD -0.70; 95 % CI -0.99 to -0.41; p < 0.001) and IL-8 (SMD -1.32; 95 % CI -2.20 to -0.45; p = 0.003). The overall number of pulmonary complications in the volatile group was smaller (RR 0.42; 95 % CI 0.23-0.77; p = 0.005) and patients in that group had significantly abridged hospitalization stay (WMD -3.59 days; 95 % CI -5.70 to -1.48 days; p = 0.001).
  
  
  CONCLUSIONS
  Inhalation anesthetics might be preferable in patients undergoing OLV for thoracic surgery and their protective effects might work via attenuating inflammatory responses.
authors.affiliation: Department of Transfusion Medicine, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Sun
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Wang
authors.forename: Lulong
authors.initials: L
authors.lastname: Bo
authors.forename: Yan
authors.initials: Y
authors.lastname: Zang
authors.forename: Haihui
authors.initials: H
authors.lastname: Gu
authors.forename: Jinbao
authors.initials: J
authors.lastname: Li
authors.forename: Baohua
authors.initials: B
authors.lastname: Qian
mesh_terms: D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000378:metabolism; D061810:One-Lung Ventilation / Q000379:methods*; D015742:Propofol / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D019616:Thoracic Surgical Procedures / Q000379:methods
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D016207:Cytokines; D015742:Propofol