Effect of parecoxib on intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection

Abstract

Objective To investigate the effect of parecoxib on intrapulmonary shunt during one-lung yentilation in patients undergoing esophageal cancer operation. Methods Forty-five ASA Ⅰ orⅡ patients of both sexes aged 47-57 yr weighing 42-59 kg undergoing esophageal cancer resection were randomly divided into 2 groups：control group （group C,n = 23） and parecoxib group （group P,n = 22）. Left radial artery and right internal jugular vein were cannulated for MAP and CVP monitoring and blood sampling. Parecoxib 40 mg in 10 ml of normal saline was injected iv slowly before induction of anesthesia in group P while in group C normal saline 10 ml was injected instead of parecoxib. Anesthesia was induced with TCI of propofol （Ce 4 μg/ml） and sufentanil （Ce 0.3 ng/ml）. Insertion of double lumen tube was facilitated with rocuronium 0.9 mg/kg. Correct position of the double lumen tube was verified by fiberoptic bronchoscopy. Anesthesia was maintained with TCI of propofol and sufentanil and intermittent iv boluses of cis-atracurium. BIS was maintained at 50-55 during operation. MAP, HR, CVP,mean airway pressure were monitored and recorded after induction of anesthesia （To）, at 15, 30 min and 1 h of OLV （T1.2.3） and 30 min and 1 h after re-expansion of the collapsed lung （T4.5）. Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt （Qs/Qt） was calculated.Results There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs/Qt during onelung ventilation between the two groups. Conclusion Parecoxib has no effect on hypoxic pulmonary vasoconstriction during one-lung ventilation in patients undergoing esophageal cancer resection. Key words: Cyclooxygenase 2 inhibitors; Pulmonary circulation; Pulmonary ventilation