Total intravenous anesthesia provided stable anesthesia, better gas exchange (median FiO2 50 vs 80), and smaller hemodynamic changes than combined endotracheal anesthesia during atrial ablation.
Does total intravenous anesthesia improve intraoperative hemodynamics and gas exchange compared to combined endotracheal anesthesia in patients undergoing thoracoscopic radiofrequency epicardial ablation of the left atrium?
Total intravenous anesthesia provides more stable anesthesia, optimal gas exchange, and better hemodynamic profiles than combined endotracheal anesthesia during thoracoscopic epicardial ablation.
Absolute Event Rate: 0% vs 0%
Thoracoscopic radiofrequency epicardial ablation of the left atrium is performed under conditions exclusive for this intervention. Anesthetic management for this surgery is not standardized. Objective. To determine the optimal anesthetic technique for thoracoscopic radiofrequency epicardial ablation of the left atrium. Material and methods. The study included 187 patients who underwent thoracoscopic radiofrequency ablation. Of these, 126 ones were in prospective part. Patients were divided into two groups according to anesthesia: total intravenous anesthesia with mechanical ventilation and combined endotracheal anesthesia. Central hemodynamics, mechanical ventilation, and acid-base status were recorded intraoperatively at three stages of intervention. We analyzed characteristics of early postoperative period and postoperative morbidity. Results. Intraoperative stage is characterized by supine position, alternate single-lung ventilation and communication between pleural cavities. The median of BIS in the combined endotracheal anesthesia group changed between stages: 67 (beginning of surgery) — 40 (main stage) — 57 (end of surgery). In the total intravenous anesthesia group, BIS was stable. At the main stage, FiO2 set to maintain optimal PaO2 and SatO2 was 80 60; 80 in the CEA group and 50 45;70 in the intravenous anesthesia group. No dependency between anesthetic technique and intra-/postoperative complications was found. Cardiac index at the beginning of surgery was higher in the total intravenous anesthesia group. Sympathomimetic support increased cardiac index to normal values. Conclusion. Total intravenous anesthesia is safe for thoracoscopic radiofrequency epicardial ablation of the left atrium regarding stable anesthesia and optimal gas exchange indicators. Total intravenous anesthesia combined with inotropic support allowed for higher cardiac index and smaller hemodynamic changes.
Marey et al. (Thu,) reported a other. Total intravenous anesthesia provided stable anesthesia, better gas exchange (median FiO2 50 vs 80), and smaller hemodynamic changes than combined endotracheal anesthesia during atrial ablation.