British Journal of Anaesthesia, Vol 75, Issue 5 578-582, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
N. H. Kellow, A. D. Scott, S. A. White and R. O. Feneck
I.v. anaesthetic agents, including propofol, have not been shown to inhibit
hypoxic pulmonary vasoconstriction (HPV). This may encourage the use of
propofol in thoracic surgery where one lung ventilation (OLV) is required.
We have compared the effects of maintaining anaesthesia with either
isoflurane or propofol infusion on right ventricular function and shunt
fraction. We studied 10 patients who received isoflurane and 12 who
received propofol. When OLV commenced there was a greater reduction in both
mean cardiac index (3.2 (SEM 0.2) to 2.4 (0.1) litre min-1 m-2 for
propofol, and 3.4 (0.2) to 3.3 (0.4) litre min-1 m-2 for isoflurane) and
right ventricular ejection fraction (0.45 (0.03) to 0.37 (0.02) for
propofol, and 0.48 (0.02) to 0.42 (0.02) for isoflurane) in patients who
received propofol. Furthermore, these reductions were sustained for longer
in the propofol group. However, propofol was not associated with a
significant increase in shunt fraction during OLV, which increased
threefold in patients who received isoflurane.
CLINICAL INVESTIGATIONS
Comparison of the effects of propofol and isoflurane anaesthesia on right ventricular function and shunt fraction during thoracic surgery
Department of Anaesthesia, London Chest Hospital, Bonner Road, London E2 9JX
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