PURPOSE:Pulmonary inflammatory reactions are affected by one-lung ventilation (OLV) and anesthetic agents. However, the effects of anesthetic agents on pulmonary inflammatory reactions may vary. Our previous investigations suggested that inflammatory reactions were more pronounced in the dependent lung during lung resection under general anesthesia with propofol and remifentanil. Therefore, in the present study we attempted to determine the difference in pulmonary inflammatory reaction using either sevoflurane or propofol in both dependent and nondependent lungs during OLV. METHODS:Forty adult patients undergoing elective lung resection were randomized to receive either propofol (n = 20) or sevoflurane (n = 20) as the main anesthetic agent. Intraoperative analgesia was provided by remifentanil in both groups. Epithelial lining fluid (ELF) was obtained from each lung using a bronchoscopic microsampling method. ELF and plasma levels of inflammatory cytokines were measured using multiplexed bead-based immunoassays before and after OLV. RESULTS:Epithelial lining fluid levels of interleukin (IL)-1β, IL-6, and IL-8 were significantly increased in the dependent lung and the nondependent lung after OLV compared with baseline levels (P < 0.05). Moreover, IL-6 ELF level in the dependent lung was significantly higher in the propofol group than in the sevoflurane group after OLV (P < 0.001). CONCLUSION: One-lung ventilation induced inflammatory responses of the bronchial epithelia in the dependent lung and the nondependent lung during lung resection. Moreover, this inflammatory response was significantly suppressed by sevoflurane compared with propofol. Furthermore, the antiinflammatory effect of sevoflurane was more pronounced in the dependent lung than in the nondependent lung during OLV.
RCT Entities:
PURPOSE: Pulmonary inflammatory reactions are affected by one-lung ventilation (OLV) and anesthetic agents. However, the effects of anesthetic agents on pulmonary inflammatory reactions may vary. Our previous investigations suggested that inflammatory reactions were more pronounced in the dependent lung during lung resection under general anesthesia with propofol and remifentanil. Therefore, in the present study we attempted to determine the difference in pulmonary inflammatory reaction using either sevoflurane or propofol in both dependent and nondependent lungs during OLV. METHODS: Forty adult patients undergoing elective lung resection were randomized to receive either propofol (n = 20) or sevoflurane (n = 20) as the main anesthetic agent. Intraoperative analgesia was provided by remifentanil in both groups. Epithelial lining fluid (ELF) was obtained from each lung using a bronchoscopic microsampling method. ELF and plasma levels of inflammatory cytokines were measured using multiplexed bead-based immunoassays before and after OLV. RESULTS: Epithelial lining fluid levels of interleukin (IL)-1β, IL-6, and IL-8 were significantly increased in the dependent lung and the nondependent lung after OLV compared with baseline levels (P < 0.05). Moreover, IL-6 ELF level in the dependent lung was significantly higher in the propofol group than in the sevoflurane group after OLV (P < 0.001). CONCLUSION: One-lung ventilation induced inflammatory responses of the bronchial epithelia in the dependent lung and the nondependent lung during lung resection. Moreover, this inflammatory response was significantly suppressed by sevoflurane compared with propofol. Furthermore, the antiinflammatory effect of sevoflurane was more pronounced in the dependent lung than in the nondependent lung during OLV.
Authors: Evans R Fernández-Pérez; Mark T Keegan; Daniel R Brown; Rolf D Hubmayr; Ognjen Gajic Journal: Anesthesiology Date: 2006-07 Impact factor: 7.892
Authors: C Madjdpour; U R Jewell; S Kneller; U Ziegler; R Schwendener; C Booy; L Kläusli; T Pasch; R C Schimmer; B Beck-Schimmer Journal: Am J Physiol Lung Cell Mol Physiol Date: 2002-10-11 Impact factor: 5.464
Authors: H Wrigge; J Zinserling; F Stüber; T von Spiegel; R Hering; S Wetegrove; A Hoeft; C Putensen Journal: Anesthesiology Date: 2000-12 Impact factor: 7.892
Authors: N M Bless; M Huber-Lang; R F Guo; R L Warner; H Schmal; B J Czermak; T P Shanley; L D Crouch; A B Lentsch; V Sarma; M S Mulligan; H P Friedl; P A Ward Journal: J Immunol Date: 2000-03-01 Impact factor: 5.422
Authors: Esther K Wolthuis; Goda Choi; Mark C Dessing; Paul Bresser; Rene Lutter; Misa Dzoljic; Tom van der Poll; Margreeth B Vroom; Markus Hollmann; Marcus J Schultz Journal: Anesthesiology Date: 2008-01 Impact factor: 7.892
Authors: Stefanie Voigtsberger; Robert A Lachmann; Anik C Leutert; Martin Schläpfer; Christa Booy; Livia Reyes; Martin Urner; Julia Schild; Ralph C Schimmer; Beatrice Beck-Schimmer Journal: Anesthesiology Date: 2009-12 Impact factor: 7.892
Authors: José Eduardo B Orosz; Mariana G Braz; Márjorie A Golim; Márcio Antônio A Barreira; Denise Fecchio; Leandro G Braz; José Reinaldo C Braz Journal: Inflammation Date: 2012-12 Impact factor: 4.092