Comparison of sevoflurane with propofol on regional cerebral oxygen saturation index of patients undergoing one-lung ventilation

Objective To compare the effects of sevoflurane and propofol anesthesia on regional cerebral oxygen saturation index and hemodynamics in patients underwent one lung ventilation. Methods Forty ASA Ⅰ or Ⅱ patients underwent elective pulmonary or mediastinal tumor resection surgery were randomly divided into 2 groups ( n =20 each): group sevoflurane (group S) and group propofol (group P). Anesthesia was induced with inhalation of 8%sevoflurane in group S or target-controlled infusion of propofol (4.5 μg/ml) in group P, until the Narcotrend decreased to 80,then vercuronium 0.15 mg/kg and fentany 3 μg/kg was administered. When the Narcotrend decreased under 55 and the TOF was 0, double lumen tube was intubated. Anesthesia was maintained with either 1.5%-4.0% sevoflurane or 2.5-5.0 μg/ml propofol in each group to maintain Narcotrend values between 26 and 55. MAP,HR,SpO2 ,rSO2 were recorded at the following time points: before induction(T0 ),4 min after induction(T1 ),immediate after intubation(T2 ),5 min after intubation(T3 ),incision(T4),30 min(T5 ),60 min after one lung ventilation(T6 ),end of the surgery(T7 )in both groups. Results Compared with T 0,MAP at T1-T 7 in group S and T1, T3-T6 in group P were significantly decreased ( P 0.05),SpO2 at T1-T4 and T7,rSO 2 at T2,T3 in both the two groups were obviously increased ( P 0.05).Compared with group P,MAP in group S was significantly lower at the time of T2 ,T6 ,T7 ( P 0.05),and the duration of induction was longer than group P ( P 0.05). Left side regional cerebral oxygen saturation index was significantly higher than those in group P at the following time points:T3 -T6( P 0.05), while right side regional cerebral oxygen saturation index was higher than group P at T4 , T7 ( P 0.05).The induction time of group S (6.38±0.81) min was significantly longer than group P (5.56±1.20) min ( P 0.05). Conclusion Compared with propofol intravenous anesthesia, patients receiving sevoflurane anesthesia had higher level of regional cerebral oxygen saturation index with more stable hemodynamics but longer duration of anesthesia induction.