Comparative Effect of Propofol and Volatile Anesthetics on Postoperative Pulmonary Complications After Lung Resection Surgery: A Randomized Clinical Trial.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE

Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins
Original Publication: Cleveland, International Anesthesia Research Society.

Anesthetics, Inhalation/*administration & dosage ; Anesthetics, Intravenous/*administration & dosage ; Desflurane/*administration & dosage ; Lung Diseases/*etiology ; Pneumonectomy/*adverse effects ; Propofol/*administration & dosage ; Sevoflurane/*administration & dosage; Adult ; Aged ; Anesthetics, Inhalation/adverse effects ; Anesthetics, Intravenous/adverse effects ; China ; Desflurane/adverse effects ; Female ; Humans ; Lung Diseases/diagnosis ; Lung Diseases/prevention & control ; Male ; Middle Aged ; One-Lung Ventilation ; Propofol/adverse effects ; Prospective Studies ; Sevoflurane/adverse effects ; Time Factors ; Treatment Outcome

Background: The effect of general anesthetics (propofol and volatile anesthetics) on pulmonary outcome after lung resection surgery with one-lung ventilation (OLV) is yet undetermined. We evaluated the effect of intravenous anesthesia (propofol) and volatile anesthesia (sevoflurane or desflurane) regimens on postoperative pulmonary complications (PPCs) in patients undergoing lung resection surgery.
Methods: This prospective, randomized controlled trial enrolled 555 adult patients scheduled for lung resection surgery with OLV. Participants were randomized to 1 of 3 general anesthetic regimens (propofol, sevoflurane, or desflurane). Standard anesthesia and ventilation protocols were followed in all groups. The primary outcome was a composite of PPCs in the first 7 postoperative days. Secondary outcomes included the severity of PPCs and major postoperative complications classification. Intergroup difference in the primary outcome was assessed for significance using the Pearson χ2 test.
Results: Of 837 patients who were assessed for eligibility, 555 were randomized and 545 were analyzed. One hundred and seventy-nine patients were assigned to the propofol group, 182 in the sevoflurane group, and 184 in the desflurane group. The incidence of PPCs did not differ between the combined volatile anesthetics (sevoflurane and desflurane) group and the propofol group (21.9% vs 24.0%; odds ratio, 0.89; 95% confidence interval, 0.58-1.35; P = .570). The PPCs grade and Clavien-Dindo scores did not differ significantly across groups.
Conclusions: In patients undergoing lung resection surgery with OLV, general anesthesia with volatile anesthetics (sevoflurane or desflurane) did not reduce PPCs compared with propofol. No difference in secondary outcomes was observed.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2021 International Anesthesia Research Society.)

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0 (Anesthetics, Inhalation)
0 (Anesthetics, Intravenous)
38LVP0K73A (Sevoflurane)
CRS35BZ94Q (Desflurane)
YI7VU623SF (Propofol)

Date Created: 20210107 Date Completed: 20211122 Latest Revision: 20230721

20240829

10.1213/ANE.0000000000005334

33410611