Effect of anesthetic methods on respiratory and lung functions of patients after sequential double lung transplantation

doi:10.3969/j.issn.2095-4344.2014.27.008

Abstract

Abstract:

BACKGROUND: In the non-extracorporeal circulation conditions, the choice of thoracic general-epidural anesthesia plus intravenous anesthesia and intravenous anesthesia alone is still controversial for sequential double lung transplantation.
OBJECTIVE: To investigate the influence of two different anesthetic methods on the respiratory function and lung biological function of the patients after treated with sequential double lung transplantation.
METHODS: The 24 patients undergoing sequential double lung transplantation were randomly divided into two groups: general anesthesia group and general anesthesia combined general-epidural anesthesia group, with 12 patients in each group. All the patients were anesthetized and were subjected to one-lung or bilateral-lung ventilations for 10 minutes. Then oxygen consumption, carbon dioxide emission, respiratory quotient and energy expenditure were measured during ventilation. At the same time, the secretion of norepinephrine, epinephrine, cortisol and glucose levels were analyzed.
RESULTS AND CONCLUSION: At 6 months, 1 year and 3 years after transplantation, the lung functions of patients in both groups were significantly improved, blood gas analysis was normal, and there was no significant difference between the two groups. The incidence of complications, acute rejection, and mortality in the two groups showed no significantly difference (P > 0.05). In general anesthesia combined general-epidural anesthesia group, the oxygen consumption, carbon dioxide emission and energy expenditure were significantly higher than those of general anesthesia group (P < 0.05). But the secretion of oxygen consumption, carbon dioxide emission and respiratory quotient in the same group were lower during one-lung-ventilation than that during bilateral-lung-ventilation, without significant differences (P > 0.05). The secretion of norepinephrine, epinephrine, cortisol and glucose levels were significantly elevated in general anesthesia combined general-epidural anesthesia group, when compared to general anesthesia group (P < 0.05). In the general anesthesia group, the secretion of cortisol during bilateral-lung-ventilation was significantly higher than that of one-lung-ventilation (P < 0.05). There was no significant difference in the norepinephrine, epinephrine, cortisol and glucose levels during one-lung-ventilation and bilateral-lung-ventilation in general anesthesia combined general-epidural anesthesia group (P > 0.05). In the lung transplantation process, general anesthesia combined general-epidural anesthesia increases the secretion of oxygen consumption, carbon dioxide emission, and energy expenditure, reduces stress reaction, compared with general anesthesia. In addition, the metabolism and stress are not mediated by the way of ventilation.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: lung transplantation, energy metabolism, anesthesia, epidural, blood gas analysis

CLC Number:

R318

Huang Le-lin. Effect of anesthetic methods on respiratory and lung functions of patients after sequential double lung transplantation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(27): 4304-4309.

Figures/Tables 5

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