Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation

Introduction With the widely used technique of One Lung Ventilation (OLV) in patients throughout thoracic surgery, it’s unclear whether inhaled or intravenous anesthetics were associated with postoperative complications. The purpose of the current study is to compare the effects of intravenous and inhaled anesthetics on the postoperative complications within the patients suffering OLV. Methods We searched the related randomized controlled trials in PubMed\EMBASE\Medline and the Cochrane library up to 09\2021.Inclusive criteria were as follows: We included all the randomized controlled trials which compared the effects of intravenous and inhaled anesthetics on the postoperative complications[listed as: (a) major complications; (b)postoperative pulmonary complications (PPCs); (c) postoperative cognitive function (MMSE score); (d) length of hospital stay; (e) 30-days mortality] for the patients undergoing one lung ventilation. Results Thirteen randomized controlled trials with 2522 patients were included for analysis. Overall, there were no significant differences in the postoperative major complications between inhaled and intravenous anesthetics groups (OR 0.78, 95%CI 0.54 to 1.13, p =0.19; I 2 =0%). However, more PPCs were detected in intravenous groups when compared to inhaled groups (OR 0.62, 95%CI 0.44 to 0.87, p =0.005; I 2 =37%). Both the postoperative MMSE scores (SMD -1.94, 95%CI -4.87 to 0.99, p =0.19; I 2 =100%) and the length of hospital stay (SMD 0.05, 95%CI -0.29 to 0.39, p =0.76; I 2 =73%) were comparable between two groups. Besides, the 30-day mortality didn’t differ significantly across groups either (OR 0.79, 95%CI 0.03 to 18, p =0.88; I 2 =63%). Conclusions In patients undergoing OLV, generous anesthesia with inhaled anesthetics could reduce PPCs compared with intravenous anesthetics, but no evident advantages were provided over other major complications, cognitive function, hospital stay or mortality.