Table 1.
Included randomized controlled trials for effects of thoracic epidural analgesia on oxygenation and pulmonary shunt fraction during One-lung ventilation
| Study | Participants | Interventions | Abstracted outcomes |
|---|---|---|---|
| Ozcan et al [5] | 25 G-TIVA | G-TIVA/ISO: induced: fentanyl (3 μg.kg−1), propofol (BIS < 45) , vecuronium (0.1 mg.kg−1) | hemodynamic variables: HR, MAP; Intrapulmonary shunt: PvO2, PaO2,Qs/Qt |
| 25G-TIVA-TEA | Maintained: propofol or isoflurane respectively (according to BIS value) | ||
| 25 G-ISO | G-TIVA/ISO-TEA: T7-T8 epidural with initial 2 % lidocaine 2 mL ,0.1 % bupivacaine +0.1 mg.kg−1 morphine 10 mL, then induced the same as G-TIVA/ISO group | ||
| 25 G-ISO-TEA | Maintained: 0.1 % bupivacaine +0.1 mg.kg−1 morphine 7 ml.h-1, and maintained with propofol or isoflurane respectively (according to BIS value) | ||
| Garutti et al. [6] | 30 G-TIVA | G-TIVA: induced: fentanyl (3 μg.kg−1), midazolam (2-3 mg) , propofol (2 mg/kg), rocuronium (0.6 mg/kg) | hemodynamic variables: HR, MAP; Intrapulmonary shunt: PvO2,PaO2,Qs/Qt,PaCO2, PH,SvO2,SaO2,CaO2,CvO2; Other: Hb, Paw |
| 30 G-TIVA-TEA | Maintained: fentanyl (3 μg.kg−1), propfol (6–7 mg.kg−1.h−1); rocuronium (0.5 mg.kg−1.h−1) | ||
| G-TIVA-TEA: T6-T7 or T7-T8 epidural with initial 6–8 ml bupivacaine, then induced: same as G-TIVA group | |||
| Maintained: 0.375 % bupivacaine (6–7 mL.h−1), propofol (6–7 mg.kg−1.h−1), rocuronium (0.6 mg/kg) | |||
| Jung et al. [8] | 13G-TIVA | G-TIVA: induced: fentanyl (50–100 μg), propofol (4–5 μg/ml), vecuronium (0.1 mg.kg−1) | hemodynamic variables: HR, MAP, CVP. MPAP, PAOP, CO, SVR, PVR; Intrapulmonary shunt: PvO2,PaO2,Qs/Qt,PaCO2, PH, SvO2,SaO2; Other: Hb, Paw |
| 13G-TIVA-TEA-B | Maintained: 20 μg/ml remifentanil, 0.2 ml.kg−1.h−1; vecuronium (2–2.5 mg..h−1), propofol (according to BIS) | ||
| 13G-TIVA-TEA-S | G-TIVA-TEA-B: T5-T6 or T6-T7 epidural with initial 10 ml 5 % bupivacaine, then induced: same as G-TIVA group. | ||
| Maintained: 0.25 % bupivacaine 0.1 ml.kg−1.h−1, propofol (6–7 mg.kg−1.h−1), vecuronium (2–2.5 mg..h−1), propofol (according to BIS) | |||
| G-TIVA-TEA-S: T5-T6 or T6-T7 epidural with initial 10 ml 50 μg sufentanil , then induced :same as G-TIVA group | |||
| Maintained: 1 μg/ml sufentanil 0.1 ml.kg−1.h−1), propofol (6–7 mg.kg−1.h−1), vecuronium (2–2.5 mg..h−1), propofol (according to BIS) | |||
| Garutti et al. [9] | 37 G-TIVA | G-TIVA: induced: fentanyl (3 μg.kg−1), midazolam (0.04 mg/kg), propofol (2 mg/kg), rocuronium (0.6 mg.kg−1) | hemodynamic variables: HR, MAP; Intrapulmonary shunt: PvO2,PaO2,Qs/Qt,PaCO2, PH,SvO2,SaO2,CaO2,CvO2; Other: Hb, Paw |
| Maintained: fentanyl (2–3 μg.kg−1), propfol (6–7 mg.kg−1.h−1); rocuronium (0.5 mg.kg−1.h−1) | |||
| 35 G-TIVA-TEA | G-TIVA-TEA: T6-T7 or T7-T8 epidural with initial meperidine 2 mg.kg−1 diluted in avolume of 10–12 mL, then induced :same as G-TIVA group | ||
| Maintained: propofol (6–7 mg.kg−1.h−1), rocuronium(0.5 mg.kg−1.h−1) | |||
| Dossow et al. [10] | 25 G-TIVA | G-TIVA: induced: fentanyl (5–10 μg.kg−1), thiopental (3–5 mg.kg−1), panccuronium (0.1 mg.kg−1) | hemodynamic variables; HR, MAP, PAOP, MPAP, CVP; Intrapulmonary shunt: PvO2,SVR,PVR |
| 25 G-TIVA-TEA | Maintained: fentanyl (5–10 μg.kg−1.h−1), propfol (6–10 mg.kg−1.h−1), panccuronium(0.05–0.15 mg.kg−1) | ||
| G-TIVA-TEA: T6–7 or T7–8 epidural with initial 0.5 % bupivacaine 15 mg, then induced the same as G-TIVA group | |||
| Maintained: 0.5 % bupivacaine (range 15–25 mg), propfol (6–10 mg.kg−1.h−1), panccuronium (0.05–0.15 mg.kg−1) | |||
| Feng Y et al. [11] | 12G-TIVA | G-TIVA: induced :fentanyl (3 μg.kg−1), propfol (1 mg.kg−1) , Vecuronim (0.1 mg.kg−1) | hemodynamic variables; HR, MAP, MPAP, CVP, CO; Intrapulmonary shunt: PaO2, PaCO2, Qs/Qt |
| Maintained: propfol (9–12 mg.kg−1.h−1), Vecuronim (0.1 mg.kg−1), T7–8 or T8–9 epidural with initial 1 % lidocaine 5 ml ,then maintained with normal saline 5 ml/h | |||
| 12G-TIVA-TEA | G-TIVA-TEA: T7–8 or T8–9 epidural with initial 0.5 % ropivacaine 7–9 ml, then induced the same as G-TIVA group. | ||
| Maintaine with epidural ropivacaine 3–5 ml.h−1 combined with propfol (4.8–7.2 mg.kg−1.h−1), Vecuronim (0.1 mg.kg−1) | |||
| Lu JH et al. [12] | 10 G-SEV | G-SEV: induced: fentanyl (100 μg ), propfol (2 mg.kg−1), vecuronim (0.1 mg.kg−1) | Intrapulmonary shunt: PaO2, PaCO2, PETCO2; Other: Hb, Paw |
| 10 G-SEV-TEA | Maintained: 0.5–1.3 MAC sevofrane, panccuronium (not mentioned) | ||
| G-SEV-TEA: T5–6 or T6–7 epidural with initial 1.0 % lidocaine 5 ml then induced as G-SEV. | |||
| Maintained: epidural with 1.0 % lidocaine 5 ml.45mins−1, combined with sevofrane(0.5–1.3MAC), panccuronium (not mentioned) | |||
| Wang et al. [13] | 30 G-TIVA | G-TIVA: induced: fentanyl (2 μg.kg−1), midazolam (0.1 mg.kg-1), propfol (1.2–2.0 mg.kg−1) , vecuronim (0.1 mg.kg−1) | Intrapulmonary shunt: PaO2, PaCO2, Qs/Qt |
| 30G-TIVA-TEA | Maintained: fentanyl (0.2 μg.kg−1.h−1), propfol (3–6 mg.kg−1.h−1), vecuronium(0.05 mg.kg−1) | ||
| G-TIVA-TEA: T6–7 epidural with initial 1.0 % lidocaine 5 ml then induced as G- TIVA. | |||
| Maintained: epidural with 1.0 % lidocaine mixed with 0.25 % bupivacaine 5 ml.h−1, combined with propfol (3–6 mg.kg−1.h−1), vecuronium(0.05 mg.kg−1) | |||
| Wang et al. [14] | 16 G-ISO | G-ISO: induced: fentanyl (2 μg.kg−1), midazolam (0.1 mg.kg-1), propfol (1.0–2.0 mg.kg−1), vecuronim (0.16 mg.kg−1) | hemodynamic variables: HR, MAP; Intrapulmonary shunt: PaO2, PaCO2, PvO2, Qs/Qt |
| 14 G-ISO-TEA | Maintained: isoflurane (2.0–4.0MAC), fentanyl (50 μg) | ||
| G-ISO-TEA: T6–7 or T7-8epidural with initial 2.0 % lidocaine 3 ml then induced as G- ISO. | |||
| Maintained: epidural with 0.5 % bupivacaine 5 ml.h−1, combined with propfol (4–6 mg.kg−1.h−1) | |||
| Wang et al. [15] | 15 G-ISO | G-ISO: induced: fentanyl (2 μg.kg−1), midazolam (0.05 mg.kg-1), propfol (1.5–2.0 mg.kg−1), vecuronim (0.1 mg.kg−1) | hemodynamic variables: HR, MAP; Intrapulmonary shunt: PaO2/Fio2, Qs/Qt Other: Paw |
| 15 G-ISO-TEA | Maintained: isoflurane (0.5–1.3MAC), vecuronim (not mentioned) | ||
| G-ISO-TEA: T10–11 epidural with initial 0.5 % lidocaine then induced as G- ISO. | |||
| Maintained: epidural with 0.5 % lidocaine 5 ml.h−1, combined with isoflurane (0.5–1.3MAC), vecuronim (not mentioned) | |||
| Chen et al. [16] | 13 G-TIVA | G-TIVA: induced: fentanyl (3 μg.kg−1), midazolam (0.1 mg.kg-1), propfol (1.0–2.0 mg.kg−1), vecuronim (0.1 mg.kg−1) | hemodynamic variables; HR, MAP; Intrapulmonary shunt: PaO2,PaCO2,PvO2,Qs/Qt, SvO2,SaO2,CaO2,CvO2, PETCO2, pH; Other: Paw |
| 13G-TIVA-TEA | Maintained: fentanyl (0.2 μg.kg−1.h−1), propfol (3–6 mg.kg−1.h−1), vecuronium(0.05 mg.kg−1) | ||
| G-TIVA-TEA: T6–7 epidural with initial 1.0 % lidocaine mixed with 0.375 % bupivacaine 8–10 ml then induced as G- TIVA. | |||
| Maintained: epidural with mixture of lidocaine and bupivacaine 5 ml.h−1, combined with propfol (3–6 mg.kg−1.h−1), vecuronium(0.05 mg.kg−1) | |||
| Wu et al. [17] | 41G-TIVA | G-TIVA: induced: midazolam (0.05 mg.kg-1), fentanil, propfol and vecuronim (no details) | hemodynamic variables; HR, MAP; Intrapulmonary shunt: PaO2,PaCO2,Qs/Qt, pH |
| 41G-TIVA-TEA | Maintained: fentanil, propfol and vecuronium (no details, according to BIS). | ||
| G-TIVA-TEA: T5–6 or T6–7 epidural with initial 0.5 % ropivacaine 7–12 ml then induced as G- TIVA. | |||
| Maintained: epidural with 0.5 % ropivacaine 4–5 ml.h−1, combined with propfol and vecuronium (no details). | |||
| Zhang et al. [18] | 43G-TIVA | G-TIVA: induced: midazolam (0.05 mg.kg-1), fentanil, propfol and vecuronim (no details) | hemodynamic variables; HR, MAP; Intrapulmonary shunt: PaO2,PaCO2,Qs/Qt, |
| 43G-TIVA-TEA | Maintained: fentanil, propfol and vecuronium (no details, according to BIS). | ||
| G-TIVA-TEA: T5–6 or T6–7 epidural with initial 0.5 % ropivacaine 7–12 ml then induced as G- TIVA. | |||
| Maintained: epidural with 0.5 % ropivacaine 4–6 ml.h−1, combined with propfol and vecuronium (no details). | |||
| Sun et al. [19] | 12 G-ISO-TEA | G-ISO-TEA and G-TIVA-TEA: induced: T7–8 or T8–9 epidural with initial 0.5 % ropivacaine 7–9 ml then induced with fentanyl (3 μg.kg−1), midazolam (2-3 mg), propfol (1.5 mg.kg−1), vecuronim (0.1 mg.kg−1) | hemodynamic variables; HR, MAP,MPAP Intrapulmonary shunt: PaO2,PaCO2,Qs/Qt, pH |
| 12 G-TIVA-TEA | |||
| Maintained: isoflurane and propfol respectively(no details, according to BIS). |
TEA thoracic epidural anesthesia with local anesthetic, opioids or both, TIVA total-intravenous anesthesia, ISO isoflurane inhalation anesthesia