Intravenous versus inhalation anaesthesia for one-lung ventilation

Background the technique called one-lung ventilation can confine bleeding or infection to one lung, prevent rupture of a lung cyst or, more commonly, facilitate surgical exposure of the unventilated lung. During one- lung ventilation, anaesthesia is maintained either by delivering a volatile anaesthetic to the ventilated lung or by infusing an intravenous anaesthetic. It is possible that the method chosen to maintain anaesthesia may affect patient outcomes.Objectives the objective of this review was to evaluate the effectiveness and safety of intravenous versus inhalation anaesthesia for one- lung ventilation.Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( the Cochrane Library 2006, Issue 3), MEDLINE, LILACS, EMBASE ( from inception to June 2006), ISI web of Science ( 1945 to June 2006), reference lists of identified trials, and bibliographies of published reviews. We also contacted researchers in the field. There were no language restrictions.Selection criteria We included randomized controlled trials and quasi- randomized controlled trials of intravenous versus inhalation anaesthesia for one-lung ventilation.Data collection and analysis Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.Main results We included nine studies that enrolled 291 participants. We could not perform meta-analyses as the included studies did not report the outcomes listed in the protocol for this review.Authors' conclusions There is no evidence from randomized controlled trials of differences in patient outcomes for anaesthesia maintained by intravenous versus inhalational anaesthesia during one- lung ventilation. This review highlights the need for continued research into the use of intravenous versus inhalation anaesthesia for one- lung ventilation. Future trials should have standardized outcome measures such as death, adverse postoperative outcomes and intraoperative awareness. Dropouts and losses to follow up should be reported.Hosp Sirio Libanes, Dept Anesthesiol, BR-05011040 São Paulo, BrazilMcMaster Univ, Toronto, ON, CanadaUniversidade Federal de São Paulo, Brazilian Cochrane Ctr, São Paulo, BrazilUniversidade Federal de São Paulo, Brazilian Cochrane Ctr, São Paulo, BrazilWeb of Scienc

Acute renal ischemia model in dogs: Effects of metoprolol

Introduction: To study the functional and hystological alterations in dog kidneys submitted to total ischemia for thirty minutes and the possible metoprolol protective action. Material and methods: Sixteen dogs anesthetized with sodium pentobarbital (SP) were studied and divided into two groups: G1-8 dogs submitted to left nephrectomy and right renal artery clamping for thirty minutes, and G2-8 dogs submitted to the same procedures of G1 and to the administration of 0.5 mg.kg(-1) metoprolol before ischemia. Attributes of renal function were studied. Results: There was acute tubular necrosis and a decrease of renal blood flow and glomerular filtration, and a increase of renal vascular resistance in both groups. Conclusion: the thirty minute renal ischemia appears to have determined the alterations found in the renal function and hystology in both groups. Metoprolol, used in G2, as to the time and dose applied didn't protect the kidney from the ischemic episode