Effect of intravenous vs. inhaled penehyclidine on respiratory mechanics in patients during one-lung ventilation for thoracoscopic surgery: a prospective, double-blind, randomised controlled trial

BMC Pulmonary Medicine

Research

Yue-ru Hou¹  Cheng-yun Xu¹  Ming-zi An²  Qing-he Zhou³  Zhen-ping Li³  Te-sheng Gao⁴ 

[1] Anesthesia Medicine, Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China;Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China;Anesthesia Medicine, Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China;Department of anaesthesiology, Jiaxing Chinese Medical Hospital, No. 1501, Zhongshan East Road, Jiaxing, Zhejiang Province, China;Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China;Department of anaesthesiology, Jiaxing Chinese Medical Hospital, No. 1501, Zhongshan East Road, Jiaxing, Zhejiang Province, China;

关键词: Driving pressure;    Mechanical power;    Postoperative pulmonary complications;    Penehyclidine;   

DOI  :  10.1186/s12890-023-02653-8

 received in 2023-06-10, accepted in 2023-09-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMinimising postoperative pulmonary complications (PPCs) after thoracic surgery is of utmost importance. A major factor contributing to PPCs is the driving pressure, which is determined by the ratio of tidal volume to lung compliance. Inhalation and intravenous administration of penehyclidine can improve lung compliance during intraoperative mechanical ventilation. Therefore, our study aimed to compare the efficacy of inhaled vs. intravenous penehyclidine during one-lung ventilation (OLV) in mitigating driving pressure and mechanical power among patients undergoing thoracic surgery.MethodsA double-blind, prospective, randomised study involving 176 patients scheduled for elective thoracic surgery was conducted. These patients were randomly divided into two groups, namely the penehyclidine inhalation group and the intravenous group before their surgery. Driving pressure was assessed at T1 (5 min after OLV), T2 (15 min after OLV), T3 (30 min after OLV), and T4 (45 min after OLV) in both groups. The primary outcome of this study was the composite measure of driving pressure during OLV. The area under the curve (AUC) of driving pressure from T1 to T4 was computed. Additionally, the secondary outcomes included mechanical power, lung compliance and the incidence of PPCs.ResultsAll 167 participants, 83 from the intravenous group and 84 from the inhalation group, completed the trial. The AUC of driving pressure for the intravenous group was 39.50 ± 9.42, while the inhalation group showed a value of 41.50 ± 8.03 (P = 0.138). The incidence of PPCs within 7 days after surgery was 27.7% in the intravenous group and 23.8% in the inhalation group (P = 0.564). No significant differences were observed in any of the other secondary outcomes between the two groups (all P > 0.05).ConclusionsOur study found that among patients undergoing thoracoscopic surgery, no significant differences were observed in the driving pressure and mechanical power during OLV between those who received an intravenous injection of penehyclidine and those who inhaled it. Moreover, no significant difference was observed in the incidence of PPCs between the two groups.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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