Intravenous versus inhalation anaesthesia for one-lung ventilation

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dc.contributor.authorMódolo, Norma Sueli Pinheiro [UNESP]
dc.contributor.authorModolo, Marilia P. [UNESP]
dc.contributor.authorMarton, Marcos A. [UNESP]
dc.contributor.authorVolpato, Enilze [UNESP]
dc.contributor.authorArantes, Vinicius Monteiro [UNESP]
dc.contributor.authorNascimento Junior, Paulo do [UNESP]
dc.contributor.authorDib, Regina Paolucci El [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-12-03T13:10:29Z
dc.date.available2014-12-03T13:10:29Z
dc.date.issued2013-01-01
dc.description.abstractBackgroundThis is an update of a Cochrane Review first published in The Cochrane Library, Issue 2, 2008.The technique called one-lung ventilation can confine bleeding or infection to one lung, prevent rupture of a lung cyst or, more commonly, facilitate surgical exposure of the unventilated lung. During one-lung ventilation, anaesthesia is maintained either by delivering an inhalation anaesthetic to the ventilated lung or by infusing an intravenous anaesthetic. It is possible that the method chosen to maintain anaesthesia may affect patient outcomes. Inhalation anaesthetics may impair hypoxic pulmonary vasoconstriction (HPV) and increase intrapulmonary shunt and hypoxaemia.ObjectivesThe objective of this review was to evaluate the effectiveness and safety of intravenous versus inhalation anaesthesia for one-lung ventilation.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL); The Cochrane Library (2012, Issue 11); MEDLINE (1966 to November 2012); EMBASE (1980 to November 2012); Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS, 1982 to November 2012) and ISI web of Science (1945 to November 2012), reference lists of identified trials and bibliographies of published reviews. We also contacted researchers in the field. No language restrictions were applied. The date of the most recent search was 19 November 2012. The original search was performed in June 2006.Selection criteriaWe included randomized controlled trials and quasi-randomized controlled trials of intravenous (e. g. propofol) versus inhalation (e. g. isoflurane, sevoflurane, desflurane) anaesthesia for one-lung ventilation in both surgical and intensive care participants. We excluded studies of participants who had only one lung (i.e. pneumonectomy or congenital absence of one lung).Data collection and analysisTwo review authors independently assessed trial quality and extracted data. We contacted study authors for additional information.Main resultsWe included in this updated review 20 studies that enrolled 850 participants, all of which assessed surgical participants no studies investigated one-lung ventilation performed outside the operating theatre. No evidence indicated that the drug used to maintain anaesthesia during one-lung ventilation affected participant outcomes. The methodological quality of the included studies was difficult to assess as it was reported poorly, so the predominant classification of bias was 'unclear'.Authors' conclusionsVery little evidence from randomized controlled trials suggests differences in participant outcomes with anaesthesia maintained by intravenous versus inhalational anaesthesia during one-lung ventilation. If researchers believe that the type of drug used to maintain anaesthesia during one-lung ventilation is important, they should design randomized controlled trials with appropriate participant outcomes, rather than report temporary fluctuations in physiological variables.en
dc.description.affiliationUniv Estadual Paulista, UNESP, Botucatu Med Sch, Dept Anaesthesiol, Botucatu, SP, Brazil
dc.description.affiliationUniv Estadual Paulista, UNESP, Botucatu Med Sch, Botucatu, SP, Brazil
dc.description.affiliationUniv Estadual Paulista, UNESP, Botucatu, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, UNESP, Botucatu Med Sch, Dept Anaesthesiol, Botucatu, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, UNESP, Botucatu Med Sch, Botucatu, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, UNESP, Botucatu, SP, Brazil
dc.format.extent58
dc.identifierhttp://dx.doi.org/10.1002/14651858.CD006313.pub3
dc.identifier.citationCochrane Database Of Systematic Reviews. Hoboken: Wiley-blackwell, n. 7, 58 p., 2013.
dc.identifier.doi10.1002/14651858.CD006313.pub3
dc.identifier.issn1469-493X
dc.identifier.lattes8223546475724058
dc.identifier.lattes8745358989680600
dc.identifier.orcid0000-0002-2323-9159
dc.identifier.orcid0000-0002-4081-803X
dc.identifier.urihttp://hdl.handle.net/11449/112175
dc.identifier.wosWOS:000322568100044
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofCochrane Database of Systematic Reviews
dc.relation.ispartofjcr6.754
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.subjectAnesthesia, Inhalationen
dc.subjectAnesthesia, Intravenousen
dc.subjectRandomized Controlled Trials as Topicen
dc.subjectRespiration, Artificial [methods]en
dc.subjectHumansen
dc.titleIntravenous versus inhalation anaesthesia for one-lung ventilationen
dc.typeArtigo
dcterms.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dcterms.rightsHolderWiley-Blackwell
unesp.author.lattes8223546475724058
unesp.author.lattes8745358989680600[6]
unesp.author.orcid0000-0002-4081-803X[7]
unesp.author.orcid0000-0002-2323-9159[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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Artigos - Anestesiologia - FMB