Intravenous versus inhalation anaesthesia for one-lung ventilation

Abstract

Background: The technique called one-lung ventilation can confine bleeding or infection to one lung, prevent rupture of a lung cyst or, more commonly, facilitate surgical exposure of the unventilated lung. During one-lung ventilation, anaesthesia is maintained either by delivering a volatile anaesthetic to the ventilated lung or by infusing an intravenous anaesthetic. It is possible that the method chosen to maintain anaesthesia may affect patient outcomes.

Objectives: The objective of this review was to evaluate the effectiveness and safety of intravenous versus inhalation anaesthesia for one-lung ventilation.

Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 3), MEDLINE, LILACS, EMBASE (from inception to June 2006), ISI web of Science (1945 to June 2006), reference lists of identified trials, and bibliographies of published reviews. We also contacted researchers in the field. There were no language restrictions.

Selection criteria: We included randomized controlled trials and quasi-randomized controlled trials of intravenous versus inhalation anaesthesia for one-lung ventilation.

Data collection and analysis: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.

Main results: We included nine studies that enrolled 291 participants. We could not perform meta-analyses as the included studies did not report the outcomes listed in the protocol for this review.

Authors' conclusions: There is no evidence from randomized controlled trials of differences in patient outcomes for anaesthesia maintained by intravenous versus inhalational anaesthesia during one-lung ventilation. This review highlights the need for continued research into the use of intravenous versus inhalation anaesthesia for one-lung ventilation. Future trials should have standardized outcome measures such as death, adverse postoperative outcomes and intraoperative awareness. Dropouts and losses to follow up should be reported.