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Microcirculation measured by vascular occlusion test during desflurane–remifentanil anesthesia is superior to that in propofol–remifentanil anesthesia in patients undergoing thoracic surgery: subgroup analysis of a prospective randomized study

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Abstract

General anesthesia can affect microcirculatory properties. However, differential effects on the microcirculation according to the anesthetic technique used during thoracoscopic surgery have not been well documented. We conducted a randomized clinical trial in which the effects of desflurane and propofol, both with remifentanil, on systemic arterial oxygenation during one-lung ventilation were compared in patients undergoing thoracoscopic surgery. As a subgroup analysis, we compared the effects of two commonly used anesthetic techniques, desflurane–remifentanil (n = 52) and propofol–remifentanil (n = 48), on tissue oxygen saturation using a vascular occlusion test in patients undergoing thoracoscopic surgery. Tissue oxygen saturation was higher in the desflurane than the propofol group (mean ± standard deviation, 83 ± 6 vs. 80 ± 9, 84 ± 6 vs. 76 ± 10, and 87 ± 7 vs. 77 ± 10 % at 30 and 60 min of one-lung ventilation and at two-lung ventilation; adjusted p = 0.026, <0.001, and <0.001, respectively). The recovery slope during the vascular occlusion test, reflecting microvascular reperfusion adequacy, was higher in the desflurane than the propofol group during surgery (mean difference, 0.5 %/s; 95 % CI 0.0–0.9 %/s; p = 0.037). Desflurane–remifentanil anesthesia is associated with better microcirculation than propofol–remifentanil anesthesia in patients undergoing thoracoscopic surgery.

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Acknowledgments

The authors thank the Medical Research Collaborating Center for their advice concerning the statistical analyses.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Youn Joung Cho, Jungil Bae, Tae Kyong Kim, Deok Man Hong, Jeong-Hwa Seo, Jae-Hyon Bahk & Yunseok Jeon

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  1. Youn Joung Cho
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  2. Jungil Bae
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  3. Tae Kyong Kim
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Correspondence to Yunseok Jeon.

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Conflict of interest

The contents of this study have not been published elsewhere nor are being submitted elsewhere. The manuscript has been read and approved by all co-authors. Hippo Medical Company (Seoul, Korea) and Hutchinson (MN, USA) provided the Inspectra™ StO2 tissue oxygenation monitor during this study. Dr. Jeon received grant support from Ilsung Pharmaceuticals (research grant for studies). The remaining authors have disclosed that they do not have any potential conflicts of interest including commercial relationships such as consultation and equity interests.

Ethical approval

All procedures performed in the study involving human participates were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Cho, Y.J., Bae, J., Kim, T.K. et al. Microcirculation measured by vascular occlusion test during desflurane–remifentanil anesthesia is superior to that in propofol–remifentanil anesthesia in patients undergoing thoracic surgery: subgroup analysis of a prospective randomized study. J Clin Monit Comput 31, 989–997 (2017). https://doi.org/10.1007/s10877-016-9937-2

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  • DOI: https://doi.org/10.1007/s10877-016-9937-2

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