Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation

Sponsor

Seoul National University Hospital (Other)

Overall Status

Completed

CT.gov ID

NCT02191371

Collaborator

(none)

104

Enrollment

Location

Arms

Duration (Months)

20.7

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

One-lung ventilation during thoracic surgery may affect systemic oxygenation and peripheral microcirculation by hypoxic pulmonary vasoconstriction. Both intravenous and inhalational anesthetics can be used during one-lung ventilation. However, there is still a controversy which anesthetic would be more appropriate during one-lung ventilation in the perspective of oxygenation and microcirculation. The investigators hypothesized that intravenous and inhalational anesthetics may affect oxygenation and microcirculation differently during one-lung ventilation.

Condition or Disease	Intervention/Treatment	Phase
Mechanical Ventilation Complication	Drug: propofol Drug: desflurane	N/A

Detailed Description

Patients undergoing thoracic surgery including one-lung ventilation will be randomized to receive intravenous (propofol) or inhalational (desflurane) anesthetic.

Systemic oxygenation can be evaluated by measuring partial pressure of oxygen in arterial blood analysis. Microcirculatory parameters can be obtained from vascular occlusion test. Among those parameters, recovery slope during vascular occlusion test is known to reflect recruitment of microvasculature in response to hypoxic or ischemic insult. In this study, we will compare arterial partial pressure of oxygen and recovery slope during one-lung ventilation between propofol and desflurane group.

Study Design

Study Type:

Interventional

Actual Enrollment :

104 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Triple (Participant, Care Provider, Investigator)

Primary Purpose:

Treatment

Official Title:

Effect of Anesthetics on Oxygenation and Microcirculation During One-lung Ventilation

Study Start Date :

Jul 1, 2014

Actual Primary Completion Date :

Dec 1, 2014

Actual Study Completion Date :

Dec 1, 2014

Arms and Interventions

Arm	Intervention/Treatment
Experimental: propofol Propofol is used as a maintenance anesthetic to patients in the propofol group. Intervention: propofol infusion by target-controlled infusion for maintaining anesthesia propofol (Fresofol MCT 2%) target effect site concentration: 4~5 mcg/ml, during general anesthesia	Drug: propofol Patients are randomized to receive intravenous anesthetic (propofol) or inhalational anesthetic (desflurane) as a maintenance anesthetic. Other Names: propofol (Fresofol(R)2 MCT 2%, Fresenius Kabi)
Experimental: desflurane Desflurane is used as a maintenance anesthetic to patients in the desflurane group. Intervention: Desflurane administration for maintaining anesthesia desflurane (Suprane) inhalation as 6~8 vol% during general anesthesia	Drug: desflurane Patients are randomized to receive intravenous anesthetic (propofol) or inhalational anesthetic (desflurane) as a maintenance anesthetic. Other Names: desflurane (Suprane(R), Baxter Healthcare)

Arm

Intervention/Treatment

Experimental: propofol

Propofol is used as a maintenance anesthetic to patients in the propofol group. Intervention: propofol infusion by target-controlled infusion for maintaining anesthesia propofol (Fresofol MCT 2%) target effect site concentration: 4~5 mcg/ml, during general anesthesia

Drug: propofol

Patients are randomized to receive intravenous anesthetic (propofol) or inhalational anesthetic (desflurane) as a maintenance anesthetic.

Other Names:

propofol (Fresofol(R)2 MCT 2%, Fresenius Kabi)

Experimental: desflurane

Desflurane is used as a maintenance anesthetic to patients in the desflurane group. Intervention: Desflurane administration for maintaining anesthesia desflurane (Suprane) inhalation as 6~8 vol% during general anesthesia

Drug: desflurane

Patients are randomized to receive intravenous anesthetic (propofol) or inhalational anesthetic (desflurane) as a maintenance anesthetic.

Other Names:

desflurane (Suprane(R), Baxter Healthcare)

Outcome Measures

Primary Outcome Measures

arterial partial pressure of oxygen [30 min after one-lung ventilation]
Primary outcome is arterial partial pressure of oxygen 30 min after one-lung ventilation during thoracic surgery in propofol and desflurane groups.

Secondary Outcome Measures

recovery slope [30 min after one-lung ventilation]
Secondary outcome is recovery slope measured by vascular occlusion test 30 min after one-lung ventilation during thoracic surgery in propofol and desflurane groups.

Other Outcome Measures

blood pressure [30 min after one-lung ventilation]

Eligibility Criteria

Criteria

Ages Eligible for Study:

20 Years to 90 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

undergoing thoracic surgery including one-lung ventilation

Exclusion Criteria:

refuse to enroll
BMI over 30 kg/m(2)
severe obstructive or restrictive lung disease
preoperative supplemental oxygen, intubated, or mechanical ventilatory support
preoperative arterial partial pressure of oxygen < 60 mmHg
pregnancy
history of coronary artery disease
preoperative continuous infusion of vasopressor or inotropes
cannot undergo vascular occlusion test: anatomical abnormality of both arms, severe peripheral vascular disease, presence of A-V fistula