Cardiothoracic & vascular anesthesia
The effects of thoracic epidural blockade on ventilation-perfusion matching during one-lung ventilation: An exploratory study
Authors' conclusion
Based on the contrast-enhanced EIT evaluation of pulmonary perfusion and ventilation, TEB appears to induce a V/Q mismatch in patients undergoing OLV in the lateral position for thoracic surgery.
Study context
- Population
- Patients undergoing thoracic surgery with one lung ventilation (OLV) in the lateral position, university-affiliated teaching hospital
- Participants
- 30 patients
- Comparison
- Thoracic epidural blockade plus GA vs control during OLV
- Primary endpoint
- Pulmonary perfusion distribution and V/Q matching (electrical impedance tomography (EIT))
- Follow-up
- 15 min after epidural administration during OLV (T2)
Methodological detailssingle-centre, prospective, unblinded, parallel-group, exploratory
- Single-centre
- Prospective
- Unblinded
- Parallel-group
- Exploratory
Primary result
As reported in the abstract
V/Q matching by EIT · T2
- Thoracic epidural blockade (TEB) increased non-ventilated perfusion distribution
- p < 0.05
- TEB increased Shunt-EIT %
- p < 0.05
- TEB reduced Matched Region %
- p < 0.05
- Dead Space-EIT % unchanged
- p = 0.499
Further findings
PaO2/FiO2
- Significantly lower in TEB after epidural local anaesthetic
- P < 0.05
- Significant decrease from T0 to T1 (OLV) in both groups
Shunt-ABG (%) · T2
- Significantly higher in TEB vs control
- P < 0.05
Safety
Haemodynamics 15 min after TEB
- MAP significantly decreased
- P < 0.05
- No significant change in heart rate among the 30 patients
- P = 0.547
Original publication
The effects of thoracic epidural blockade on ventilation-perfusion matching during one-lung ventilation: An exploratory study. J Clin Anesth. Published 6 November 2024. doi:10.
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