Effects of sevoflurane and propofol on right ventricular function and pulmonary circulation in patients undergone esophagectomy
Wen-Yun Xu, Na Wang, Hai-Tao Xu, Hong-Bin Yuan, Hai-Jing Sun, Chun-Li Dun, Shuang-Qiong Zhou, Zui Zou, Xue-Yin Shi, Wen-Yun Xu, Na Wang, Hai-Tao Xu, Hong-Bin Yuan, Hai-Jing Sun, Chun-Li Dun, Shuang-Qiong Zhou, Zui Zou, Xue-Yin Shi
Abstract
Object: Sevoflurane and propofol are both widely used in clinical anesthesia. The aim of this study is to compare the effects of sevoflurane and propofol on right ventricular function and pulmonary circulation in patients receiving esophagectomy.
Methods: Forty adult patients undergoing an elective open-chest thoracotomy for esophagectomy were randomized to receive either propofol (n=20) or sevoflurane (n=20) as the main anesthetic agent. The study was performed in Changzheng Hospital. Hemodynamic data were recorded at specific intervals: before the surgery (T0), BIS values reaching 40 after anesthesia induction (T1), two-lung ventilation (T2), ten minutes after one-lung ventilation (T3), the end of the operation (T4) using PiCCO2 and Swan-Ganz catheter.
Results: CI, RVEF, RVSWI and RVEDVI were significantly smaller in propofol group than those in sevoflurane group throughout the surgery (P<0.05). However, SVRI was significantly greater in propofol group than that in sevoflurane group (P<0.05). Compared with the patients in propofol group, the patients who received sevoflurane had a greater reduction in OI and increase in Os/Ot (P<0.05). And, PVRI was significantly smaller in sevoflurane group than in propofol group (P<0.05).
Conclusion: Anesthesia with sevoflurane preserved better right ventricular function than propofol in patients receiving esophagectomy. However, propofol improved oxygenation and shunt fraction during one-lung ventilation compared with sevoflurane anesthesia. To have the best effect, anesthesiologists can choose the two anesthetics flexibly according to the monitoring results.
Keywords: Sevoflurane; esophagectomy; propofol; pulmonary circulation; right ventricular function.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3885482/bin/ijcep0007-0272-f1.jpg)
Figure 2
Changes in right ventricular function…
Figure 2
Changes in right ventricular function data at after anesthesia induction (T1), two lung…
Figure 3
Changes in pulmonary circulation data…
Figure 3
Changes in pulmonary circulation data at two lung ventilation (T2), one lung ventilation…
- Effects of propofol or sevoflurane anesthesia on the perioperative inflammatory response, pulmonary function and cognitive function in patients receiving lung cancer resection.Tian HT, Duan XH, Yang YF, Wang Y, Bai QL, Zhang X. Tian HT, et al. Eur Rev Med Pharmacol Sci. 2017 Dec;21(23):5515-5522. doi: 10.26355/eurrev_201712_13943. Eur Rev Med Pharmacol Sci. 2017. PMID: 29243798
- Cardioprotective effects of sevoflurane, isoflurane, and propofol in coronary surgery patients: a randomized controlled study.Yildirim V, Doganci S, Aydin A, Bolcal C, Demirkilic U, Cosar A. Yildirim V, et al. Heart Surg Forum. 2009 Jan;12(1):E1-9. doi: 10.1532/HSF98.20081137. Heart Surg Forum. 2009. PMID: 19233758 Clinical Trial.
- Jugular bulb venous oxygen saturation during one-lung ventilation under sevoflurane- or propofol-based anesthesia for lung surgery.Iwata M, Inoue S, Kawaguchi M, Takahama M, Tojo T, Taniguchi S, Furuya H. Iwata M, et al. J Cardiothorac Vasc Anesth. 2008 Feb;22(1):71-6. doi: 10.1053/j.jvca.2007.03.012. Epub 2007 Jun 27. J Cardiothorac Vasc Anesth. 2008. PMID: 18249334 Clinical Trial.
- Propofol for Anesthesia and Postoperative Sedation Resulted in Fewer Inflammatory Responses than Sevoflurane Anesthesia and Midazolam Sedation after Thoracoabdominal Esophagectomy.Nakanuno R, Yasuda T, Hamada H, Yoshikawa H, Nakamura R, Saeki N, Kawamoto M. Nakanuno R, et al. Hiroshima J Med Sci. 2015 Sep;64(3):31-7. Hiroshima J Med Sci. 2015. PMID: 26688994
- Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy.Wakabayashi S, Yamaguchi K, Kumakura S, Murakami T, Someya A, Kajiyama Y, Nagaoka I, Inada E. Wakabayashi S, et al. Int J Mol Med. 2014 Jul;34(1):137-44. doi: 10.3892/ijmm.2014.1762. Epub 2014 Apr 29. Int J Mol Med. 2014. PMID: 24788377 Clinical Trial.
- Effects of propofol and inhaled anesthetics on postoperative complications for the patients undergoing one lung ventilation: A meta-analysis.Yang J, Huang Q, Cao R, Cui Y. Yang J, et al. PLoS One. 2022 Oct 20;17(10):e0266988. doi: 10.1371/journal.pone.0266988. eCollection 2022. PLoS One. 2022. PMID: 36264981 Free PMC article.
- Inhalational versus intravenous anesthetics during one lung ventilation in elective thoracic surgeries: A narrative review.Parab S, Gaikwad S, Majeti S. Parab S, et al. Saudi J Anaesth. 2021 Jul-Sep;15(3):312-323. doi: 10.4103/sja.sja_1106_20. Epub 2021 Jun 19. Saudi J Anaesth. 2021. PMID: 34764838 Free PMC article. Review.
- Epidural analgesia and avoidance of blood transfusion are associated with reduced mortality in patients with postoperative pulmonary complications following thoracotomic esophagectomy: a retrospective cohort study of 335 patients.Kaufmann KB, Baar W, Glatz T, Hoeppner J, Buerkle H, Goebel U, Heinrich S. Kaufmann KB, et al. BMC Anesthesiol. 2019 Aug 22;19(1):162. doi: 10.1186/s12871-019-0832-5. BMC Anesthesiol. 2019. PMID: 31438866 Free PMC article.
- Application of standardized hemodynamic protocols within enhanced recovery after surgery programs to improve outcomes associated with anastomotic leak and conduit necrosis in patients undergoing esophagectomy.Klevebro F, Boshier PR, Low DE. Klevebro F, et al. J Thorac Dis. 2019 Apr;11(Suppl 5):S692-S701. doi: 10.21037/jtd.2018.11.141. J Thorac Dis. 2019. PMID: 31080646 Free PMC article. Review.
- The Effect of Sevoflurane Plus Propofol on Pain and Complications after Laminectomy: A Randomized Double Blind Clinical Trial.Vasigh A, Najafi F, Jaafarpour M, Khajavikhan J, Khani A. Vasigh A, et al. J Clin Diagn Res. 2017 Apr;11(4):UC05-UC08. doi: 10.7860/JCDR/2017/23565.9643. Epub 2017 Apr 1. J Clin Diagn Res. 2017. PMID: 28571236 Free PMC article.
- Randomized Controlled Trial
- Research Support, Non-U.S. Gov't
- Anesthetics / adverse effects*
- Esophagectomy / methods*
- Female
- Hemodynamics / drug effects
- Humans
- Male
- Methyl Ethers / adverse effects*
- Middle Aged
- Propofol / adverse effects*
- Pulmonary Circulation / drug effects*
- Sevoflurane
- Ventricular Function, Right / drug effects*
- Anesthetics
- Methyl Ethers
- Sevoflurane
- Propofol
- Full Text Sources
- Medical
- Miscellaneous
NCBI Literature Resources
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3885482/bin/ijcep0007-0272-f2.jpg)
Figure 3
Changes in pulmonary circulation data…
Figure 3
Changes in pulmonary circulation data at two lung ventilation (T2), one lung ventilation…
- Effects of propofol or sevoflurane anesthesia on the perioperative inflammatory response, pulmonary function and cognitive function in patients receiving lung cancer resection.Tian HT, Duan XH, Yang YF, Wang Y, Bai QL, Zhang X. Tian HT, et al. Eur Rev Med Pharmacol Sci. 2017 Dec;21(23):5515-5522. doi: 10.26355/eurrev_201712_13943. Eur Rev Med Pharmacol Sci. 2017. PMID: 29243798
- Cardioprotective effects of sevoflurane, isoflurane, and propofol in coronary surgery patients: a randomized controlled study.Yildirim V, Doganci S, Aydin A, Bolcal C, Demirkilic U, Cosar A. Yildirim V, et al. Heart Surg Forum. 2009 Jan;12(1):E1-9. doi: 10.1532/HSF98.20081137. Heart Surg Forum. 2009. PMID: 19233758 Clinical Trial.
- Jugular bulb venous oxygen saturation during one-lung ventilation under sevoflurane- or propofol-based anesthesia for lung surgery.Iwata M, Inoue S, Kawaguchi M, Takahama M, Tojo T, Taniguchi S, Furuya H. Iwata M, et al. J Cardiothorac Vasc Anesth. 2008 Feb;22(1):71-6. doi: 10.1053/j.jvca.2007.03.012. Epub 2007 Jun 27. J Cardiothorac Vasc Anesth. 2008. PMID: 18249334 Clinical Trial.
- Propofol for Anesthesia and Postoperative Sedation Resulted in Fewer Inflammatory Responses than Sevoflurane Anesthesia and Midazolam Sedation after Thoracoabdominal Esophagectomy.Nakanuno R, Yasuda T, Hamada H, Yoshikawa H, Nakamura R, Saeki N, Kawamoto M. Nakanuno R, et al. Hiroshima J Med Sci. 2015 Sep;64(3):31-7. Hiroshima J Med Sci. 2015. PMID: 26688994
- Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy.Wakabayashi S, Yamaguchi K, Kumakura S, Murakami T, Someya A, Kajiyama Y, Nagaoka I, Inada E. Wakabayashi S, et al. Int J Mol Med. 2014 Jul;34(1):137-44. doi: 10.3892/ijmm.2014.1762. Epub 2014 Apr 29. Int J Mol Med. 2014. PMID: 24788377 Clinical Trial.
- Effects of propofol and inhaled anesthetics on postoperative complications for the patients undergoing one lung ventilation: A meta-analysis.Yang J, Huang Q, Cao R, Cui Y. Yang J, et al. PLoS One. 2022 Oct 20;17(10):e0266988. doi: 10.1371/journal.pone.0266988. eCollection 2022. PLoS One. 2022. PMID: 36264981 Free PMC article.
- Inhalational versus intravenous anesthetics during one lung ventilation in elective thoracic surgeries: A narrative review.Parab S, Gaikwad S, Majeti S. Parab S, et al. Saudi J Anaesth. 2021 Jul-Sep;15(3):312-323. doi: 10.4103/sja.sja_1106_20. Epub 2021 Jun 19. Saudi J Anaesth. 2021. PMID: 34764838 Free PMC article. Review.
- Epidural analgesia and avoidance of blood transfusion are associated with reduced mortality in patients with postoperative pulmonary complications following thoracotomic esophagectomy: a retrospective cohort study of 335 patients.Kaufmann KB, Baar W, Glatz T, Hoeppner J, Buerkle H, Goebel U, Heinrich S. Kaufmann KB, et al. BMC Anesthesiol. 2019 Aug 22;19(1):162. doi: 10.1186/s12871-019-0832-5. BMC Anesthesiol. 2019. PMID: 31438866 Free PMC article.
- Application of standardized hemodynamic protocols within enhanced recovery after surgery programs to improve outcomes associated with anastomotic leak and conduit necrosis in patients undergoing esophagectomy.Klevebro F, Boshier PR, Low DE. Klevebro F, et al. J Thorac Dis. 2019 Apr;11(Suppl 5):S692-S701. doi: 10.21037/jtd.2018.11.141. J Thorac Dis. 2019. PMID: 31080646 Free PMC article. Review.
- The Effect of Sevoflurane Plus Propofol on Pain and Complications after Laminectomy: A Randomized Double Blind Clinical Trial.Vasigh A, Najafi F, Jaafarpour M, Khajavikhan J, Khani A. Vasigh A, et al. J Clin Diagn Res. 2017 Apr;11(4):UC05-UC08. doi: 10.7860/JCDR/2017/23565.9643. Epub 2017 Apr 1. J Clin Diagn Res. 2017. PMID: 28571236 Free PMC article.
- Randomized Controlled Trial
- Research Support, Non-U.S. Gov't
- Anesthetics / adverse effects*
- Esophagectomy / methods*
- Female
- Hemodynamics / drug effects
- Humans
- Male
- Methyl Ethers / adverse effects*
- Middle Aged
- Propofol / adverse effects*
- Pulmonary Circulation / drug effects*
- Sevoflurane
- Ventricular Function, Right / drug effects*
- Anesthetics
- Methyl Ethers
- Sevoflurane
- Propofol
- Full Text Sources
- Medical
- Miscellaneous
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3885482/bin/ijcep0007-0272-f3.jpg)
Source: PubMed