The haemodynamic and respiratory effects of propofol and desflurane anaesthesia for lung surgery with one-lung ventilation: a comparative study

Background: General anaesthesia with one lung ventilation (OLV) is always associated with cardiac and respiratory dysfunction. Studies comparing the haemodynamic and respiratory effects of propofol and desfluran are not available.

Aim: To compare haemodynamic and ventilation variables of general anaesthesia with desflurane or propofol, combined with thoracic epidural anaesthesia during OLV for lobectomy.

Material and methods: 40 ASA I-III patients qualified for elective lobectomy for lung cancer were randomized to receive general anaesthesia with either propofol (n = 20) or desfluran (n = 20) combined with thoracic epidural anaesthesia. The oesophageal Doppler ultrasound probe was inserted for non-invasive, continuous monitoring of: aortic blood flow, mean arterial pressure (MAP), heart rate (HR), stroke volume (SV), systemic vascular resistance index (TSVRI) and cardiac index (CI). Arterial blood samples were taken to obtain partial pressure of the oxygen (paO2), carbon dioxide (paCO2) and oxygen saturation (SaO2). Peak inspiratory pressure (PIP) and plateau pressure were also recorded.

Results: Haemodynamic parameters were stable during the procedure in both study groups. Stroke volume was significantly lower in propofol group from 30 min after starting OLV comparing to baseline. TSVRI was higher in propofol group in all time points. PaCO2 and PIP were increased in propofol group (p < 0.001) comparing to desflurane group.

Conclusions: The haemodynamic and respiratory effects of desflurane have been extensively studied but its effect during OLV has not been well documented yet. Although there were some differences in respiratory and haemodynamic parameters between two study groups, they were mostly not clinically important and did not require emergency interventions. Both agents have similar usefulness and safety profile for OLV anaesthesia.