Química medicinal

Comparison of Acid-base Status and Hemodynamic Stability during Propofol and Sevoflurane-based Anesthesia in Patients Undergoing One Lung Ventilation

Abstract

Rui Yang, Zhi-Xin Gao, Dan Zhao and Guang-Hong Xu

Background: This study compared the effects of Propofol and Sevoflurane anesthesia on the stabilization of acid-base values and hemodynamic parameters during one lung ventilation (OLV).

Methods: Patients with OLV were randomized two groups: the Propofol group (Group P, n=23) and the Sevoflurane group (Group S, n=23). In Group P, patients were induced and maintained with Propofol. In Group S, patients were induced with Propofol and maintained with Sevoflurane. Blood samples were obtained one minute before OLV (t₁) and 1, 2 hours (t₂, t₃) after OLV. Hemodynamic values were recorded at patients entered operation room (T₁); one minute before intubation (T₂); 1, 3, and 5 minutes after intubation (T₃, T₄, T₅); one minute before OLV (T₆); and 1, 2 hours after OLV (T₇, T₈).

Results: There were significant differences between different time points in pH value, base excess, and bicarbonate (P<0.001). The values of pH, base excess and bicarbonate in two groups both tended to reduce progressively from t₁ to t₃. There were no significant differences between the groups at all of the time points. There were significant differences between the different time points in terms of mean arterial pressure and heart rate (P<0.001), more patients in Group P received Nicardipine for hypertension (P<0.001). However, there were no significant intergroup differences.

Conclusions: The duration of one lung ventilation, anesthesia and operation, rather than the anaesthetic used, are key factors in maintaining acid-base balance during OLV. Sevoflurane anesthesia is superior to Propofol anesthesia in avoiding the fluctuation of hemodynamic parameters.