The effect of hypercapnia and hypertension on cerebral oxygen balance during one-lung ventilation for lung surgery during propofol anesthesia

Study objective: To investigate whether jugular bulb venous oxygen saturation (SjO(2)) values increased with induced hypercapnia or induced hypertension during propofol-based anesthesia for one-lung ventilation (OLV). Design: Prospective clinical study. Setting: Operating room at University hospital. Participants: 15 adult patients scheduled for elective thoracic procedures in the lateral position. Interventions: General anesthesia was maintained with propofol combined with epidural anesthesia. During OLV, hypercapnia (PaCO2 = 50 mmHg) and hypertension (20% increase in mean arterial pressure) were applied. Measurements: SjO2 values were measured. Main results: With hypercapnia, SjO(2) values increased 30 +/- 18% (from 54.3 +/- 8.8% to 69.3 +/- 6.3%). With hypertension, SjO(2) values were increased by 9 +/- 18% (from 54.4 +/- 9.0% to 58.5 +/- 8.8%). These changes were significantly different. No significant differences regarding SaO(2) were observed during OLV in the experimental period. Conclusion: Hypercapnia, not hypertension, significantly improved cerebral oxygen balance without observed side effects during propofol anesthesia. (C) 2010 Elsevier Inc. All rights reserved.