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

Study objectiveTo investigate whether jugular bulb venous oxygen saturation (SjO2) values increased with induced hypercapnia or induced hypertension during propofol-based anesthesia for one-lung ventilation (OLV).DesignProspective clinical study.SettingOperating room at University hospital.Participants15 adult patients scheduled for elective thoracic procedures in the lateral position.InterventionsGeneral 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.MeasurementsSjO2 values were measured.Main resultsWith hypercapnia, SjO2 values increased 30 ± 18% (from 54.3 ± 8.8% to 69.3 ± 6.3%). With hypertension, SjO2 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 SaO2 were observed during OLV in the experimental period.ConclusionHypercapnia, not hypertension, significantly improved cerebral oxygen balance without observed side effects during propofol anesthesia.