Document Detail


Quantitative analysis of changes in blood concentrations and 'presumed effect-site concentration' of sevoflurane during one-lung ventilation.
MedLine Citation:
PMID:  22734829     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
During one-lung ventilation, ventilation-perfusion mismatch decreases the arterial concentration of inhaled anaesthetics due to the arterial-to-venous concentration difference. This study tested the hypothesis that in humans, the 'presumed effect-site concentration' (taken as the mid-point between the arterial and superior jugular venous concentrations) of inhaled anaesthetic falls during one-lung (vs two-lung) ventilation. Four patients scheduled for elective prostatectomy (two-lung ventilation) and four patients for elective thoracotomy (one-lung ventilation) were randomly selected and assigned to receive sevoflurane (vaporiser-dial setting, 1.5%). Sevoflurane concentrations were measured periodically from radial artery and superior jugular vein (via a catheter advanced cephalad from the jugular vein). During one-lung ventilation, the end-expiratory sevoflurane concentration was stable at ∼1.3% but the mean (SD) presumed effect-site concentration declined initially from 58 (6.7) to 43 (4.7) μg.ml(-1) (p = 0.011) before slowly recovering. A period of insufficient depth of anaesthesia is thus a risk during one-lung ventilation.
Authors:
S Matsuse; Y Hara; T Ohkura; N Yahagi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-27
Journal Detail:
Title:  Anaesthesia     Volume:  -     ISSN:  1365-2044     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
 Staff Physician, Department of Anaesthesia, Kasukabe-chuo General Hospital, Saitama, Japan, and Graduate Student, Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan  Department Chief, Department of Anaesthesia, Kasukabe-chuo General Hospital, Saitama, Japan  Executive Scientist, Department of Clinical Development, Maruishi Pharmaceutical Co. Ltd., Osaka, Japan  Professor and Department Chair, Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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