Ryosuke Kawanishi, Nami Kakuta, Yoko Sakai, Yuki Hari, Hideto Sasaki, Ryo Sekiguchi and Katsuya Tanaka : Desflurane improves lung collapse more than propofol during one-lung ventilation and reduces operation time in lobectomy by video-assisted thoracic surgery: a randomized controlled trial, BMC Anesthesiology, 22, 1, 125, 2022.
(Summary)
This study evaluated whether desflurane improved lung collapse during one-lung ventilation (OLV) more than propofol, and whether it could reduce the operation time of video-assisted thoracic surgery. Sixty patients undergoing lobectomy by video-assisted thoracic surgery (VATS) were randomly assigned to general anesthesia with desflurane or propofol. Lungs were inspected by thoracoscope at 10, 30, and 60 min after initiation of OLV. After surgery, the Lung Collapse Score, a composite of lung color and volume assessments, was assigned by two clinicians blinded to the anesthetic regimen. The primary outcome was operation time. The secondary outcome included the complication rate. Of the 60 participants, 50 completed the study, 26 in Desflurane group and 24 in Propofol group. The Lung Collapse Scores at 30 and 60 min after OLV initiation were significantly better in Desflurane group than in Propofol group, and operation time was significantly shorter in Desflurane group (214 (57) min vs. 262 (72) min [mean (SD)], difference in means, -48; 95% CI, -85 to -11; P = 0.01). The incidence of multiple complications was 1/26 (3%) and 6/24 (25%) in Desflurane and Propofol group, respectively (relative risk, 0.1; 95% CI, 0.02 to 1.18; P = 0.04). Desflurane improved lung collapse during OLV and significantly shortened VATS lobectomy operation time compared to propofol in our studied patients. Desflurane resulted in fewer postoperative complications. Thus, desflurane may be an appropriate anesthetic during lobectomy by VATS requiring OLV. The study was registered with the University Hospital Medical Information Network ( UMIN000009412 ). The date of disclosure of this study information is 27/11/2012. On this date, we registered the study into UMIN; patients were included from 2013 to 2014. However, on 11/27/2015, the UMIN system administrator suggested a detailed description. Thereafter, we added it to the Randomization Unit. Despite being prospective, it was retrospectively registered on UMIN for the above reasons.
Hiroki Yonezawa, Ryosuke Kawanishi, Hideto Sasaki, Yohei Sogabe, Kentaro Hirota, Yasuto Honda and Katsuya Tanaka : Insertion of a fogarty catheter through a slip joint section for neonatal and infantile one-lung ventilation: A report of two cases, The Journal of Medical Investigation : JMI, 68, 1.2, 209-212, 2021.
(Summary)
Here, we report two cases involving a neonate and child in which a slip joint section was used to thread a Fogarty catheter into the endotracheal tube for one-lung ventilation (OLV). Both the neonate and infant required OLV, and were placed under general anesthesia. A Fogarty catheter was used for OLV. The Fogarty catheter was passed into the intraluminal side of the endotracheal tube through a slip joint section. OLV was maintained successfully without severe air leakage or Fogarty catheter displacement. The neonate had been intubated pre-operatively with a 3.5-mm inner diameter endotracheal tube, and we used that tube. These cases indicate that the technique can be applied to pre-operatively intubated patients and does not require surgeons to exchange endotracheal tubes. Use of the slip joint section technique facilitates Fogarty catheter fixation without additional dead space. J. Med. Invest. 68 : 209-212, February, 2021.