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CARDIOVASCULAR ANESTHESIA

The Effects of Xenon or Nitrous Oxide Supplementation on Systemic Oxygenation and Pulmonary Perfusion During One-Lung Ventilation in Pigs

Konrad Schwarzkopf, MD^*, Torsten Schreiber, MD^*, Elke Gaser, MD^*, Niels-Peter Preussler, MD^*, Lars Hueter, MD^*, Harald Schubert, DVM, Helga Rek^*, and Waheedullah Karzai, MD

*Department of Anesthesiology and Intensive Care Medicine and Institute for Experimental Animals, University of Jena; and Department of Anesthesiology and Intensive Care Medicine, Zentralklinik Bad Berka, Germany

Address correspondence and reprint requests to Konrad Schwarzkopf, MD, Department of Anesthesiology and Intensive Care Medicine, University Hospital, 07740 Jena, Germany. Address e-mail to konrad.schwarzkopf{at}med.uni-jena.de.

During experimental one-lung ventilation (OLV), the type of anesthesia may alter systemic hemodynamics, lung perfusion, and oxygenation. We studied whether xenon (Xe) or nitrous oxide (N₂O) added to propofol anesthesia would affect oxygenation, lung perfusion, and systemic and pulmonary hemodynamics during OLV in a pig model. Nine pigs were anesthetized, tracheally intubated, and mechanically ventilated. After placement of arterial and pulmonary artery catheters, a left-sided double-lumen tube was placed via tracheotomy. IV anesthesia with propofol was supplemented in random order with N₂O/O₂ 60:40 or Xe/O₂ 60:40 or N₂/O₂ 60:40. All measurements were made after stabilization at each concentration. Differential lung perfusion was measured with colored microspheres. Oxygenation (Pao₂: 90 ± 17, 95 ± 20, and 94 ± 20 mm Hg for N₂/O₂, N₂O/O₂, and Xe/O₂) and left lung perfusion (16% ± 5%, 14% ± 6%, and 18.8% for N₂/O₂, N₂O/O₂, and Xe/O₂) during OLV did not differ among the 3 groups. However, mean arterial blood pressure (78 ± 25, 62 ± 23, and 66 ± 23 mm Hg for N₂/O₂, N₂O/O₂, and Xe/O₂) and mixed venous saturation (55% ± 12%, 48% ± 12%, and 50% ± 12% for N₂/O₂, N₂O/O₂, and Xe/O₂) were reduced during N₂O/O₂ as compared with the control group (N₂/O₂). Supplementation of IV anesthesia with Xe or N₂O does not impair oxygenation nor alter lung perfusion during experimental OLV.

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