Effects Of Thoracic Epidural Anesthesia Combined With General Anwsthesia On Arterial Oxygenation And Intrapulmonary Shunting During One-Lung Ventilation: A Systematic Review

0bjective To evaluate the effectiveness of thoracic epidural anesthesia(TEA) combined with general anesthesia(GA) versus general anesthesia(GA) on arterial oxygenation and intrapulmonary shunting during one-lung ventilation (OLV)Methods We conducted an electronic search of the literature in the Cochrane Library (Issue4,2009),the specialized trials registered in the Cochrane anesthesia group,PubMed(1966 to Dec.2009),EMbase(1966 to Dec.2008),CBM(1978 to Dec.2009),VIP(1989 to Dec.2009),CNKI(1915 to Dec.2009)and hand searched some Clinical anesthesia Journals and Chinese anesthesia journals.Randomized controlled trials (RCTs) of the effectiveness of TEA combined with GA versus GA on arterial oxygenation and intrapulmonary shunting during OLV were included,The methodological quality of included RCTs was evaluated by two reviewers independently,Meta-analysis was conducted using RevMna 5.0 software.Results ten RCTs including 506 patients were identified.The results of meta-analyses showed that there were no significant differences in arterial oxy- genation and intrapulmonary shunting during OLV at different times of 5,15,20,30,and 60minutes after OLV.Conclusion Both TEA combined with GA and GA have no significant diff- erences in arterial oxygenation and intrapulmonary shunting during OLV,and have the same Security during OLV.But owing to the low quality and small sample size of the included studies,so more well-designed,large sample size RCTS are needed.