Protective effect of sevoflurane on lung function of elderly chronic obstructive pulmonary disease patients undergoing total hip arthroplasty

Table 1 Baseline characteristics of the study population

Variables	Sevoflurane group	Propofol group	P value
Age (yr)	70.3 ± 4.2	69.8 ± 3.9	0.54
Sex (male/female)	28/32	26/34	0.72
BMI (kg/m2)	24.5 ± 2.8	25.1 ± 3.1	0.31
ASA class (I/II/III)	0/36/24	0/38/22	0.81
COPD stage (II/III/IV)	24/28/8	22/30/8	0.83
Smoking history (pack-years)	18.6 ± 6.4	19.2 ± 7.1	0.62
Preoperative FEV1 (% predicted)	58.7 ± 12.3	59.4 ± 11.9	0.74
Preoperative FVC (% predicted)	65.2 ± 13.6	66.1 ± 12.8	0.67
Preoperative PEF (% predicted)	54.3 ± 10.9	55.2 ± 11.2	0.59
Primary site of BTC (ICC/ECC/GBC)	32/16/12	34/14/12	0.86
Tumor stage (I/II/III/IV)	12/24/20/4	14/22/18/6	0.79
Type of hepatectomy (minor/major)	36/24	38/22	0.81
Bile duct resection (yes/no)	20/40	18/42	0.72
Surgical duration (min)	165 ± 35	170 ± 40	0.42
Intraoperative blood loss (mL)	420 ± 180	430 ± 190	0.68
Intraoperative transfusion (yes/no)	16/44	14/46	0.74

BMI: Body mass index; ASA: American Society of Anesthesiologists; COPD: Chronic obstructive pulmonary disease; FEV1: Forced expiratory volume in 1 s; FVC: Forced vital capacity; PEF: Peak expiratory flow; BTC: Biliary tract cancer; ICC: Intrahepatic cholangiocarcinoma; ECC: Extrahepatic cholangiocarcinoma; GBC: Gallbladder cancer.

Table 2 Postoperative outcomes of the study population

Variables	Sevoflurane group	Propofol group	P value
PPCs (yes/no)	6/54	15/45	0.02
Type of PPCs (n)
Pneumonia	2	4	0.67
Atelectasis	3	9	0.14
Respiratory failure	1	2	1.00
Bronchospasm	0	1	1.00
Pleural effusion	0	1	1.00
Severity of PPCs (n)
Grade I	3	7	0.32
Grade II	2	7	0.14
Grade III	1	1	> 0.991
FEV1 (% predicted)
Preoperatively	58.7 ± 12.3	58.4 ± 11.9	0.74
24 h postoperatively	52.3 ± 11.7	48.2 ± 10.8	0.03
48 h postoperatively	54.6 ± 12.1	50.1 ± 11.2	0.02
FVC (% predicted)
Preoperatively	65.2 ± 13.6	66.1 ± 12.8	0.67
24 h postoperatively	59.4 ± 13.2	54.8 ± 12.4	0.01
48 h postoperatively	61.7 ± 13.5	56.3 ± 12.7	0.01
PEF (% predicted)
Preoperatively	54.3 ± 10.9	55.2 ± 11.2	0.59
24 h postoperatively	49.5 ± 10.7	45.6 ± 10.3	0.02
48 h postoperatively	51.8 ± 11.1	47.4 ± 10.6	0.01
IL-6 (pg/mL)
Preoperatively	15.4 ± 4.2	15.6 ± 4.5	0.81
24 h postoperatively	25.2 ± 6.3	30.8 ± 7.1	< 0.01
TNF-α (pg/mL)
Preoperatively	8.6 ± 2.1	8.7 ± 2.3	0.88
24 h postoperatively	12.4 ± 3.2	15.6 ± 3.7	< 0.01
MDA (nmol/mL)
Preoperatively	1.8 ± 0.5	1.9 ± 0.6	0.62
24 h postoperatively	2.6 ± 0.7	3.2 ± 0.8	< 0.01
8-OHdG (ng/mL)
Preoperatively	5.4 ± 1.2	5.6 ± 1.3	0.74
24 h postoperatively	7.2 ± 1.6	8.8 ± 1.9	< 0.01
VAS at rest (0-10)
6 h postoperatively	2.4 ± 1.1	3.2 ± 1.3	< 0.01
12 h postoperatively	2.1 ± 1.0	2.9 ± 1.2	< 0.01
24 h postoperatively	1.8 ± 0.9	2.6 ± 1.1	< 0.01
VAS during movement (0-10)
6 h postoperatively	4.2 ± 1.4	5.4 ± 1.6	< 0.01
12 h postoperatively	3.8 ± 1.3	5.0 ± 1.5	< 0.01
24 h postoperatively	3.4 ± 1.2	4.6 ± 1.4	< 0.01
Length of hospital stay (d)	12 (10-14)	18 (15-21)	< 0.011
Morbidity (yes/no)	8/52	18/42	< 0.011
Mortality (yes/no)	2/58	3/57	> 0.991
Recurrence-free survival (mo)
Median	18	19	0.38
95%CI	15-21	16-22
Overall survival (mo)
Median	24	25	0.46
95%CI	21-27	22-28

¹Mann-Whitney U test.

PPCs: Postoperative pulmonary complications; FEV1: Forced expiratory volume in 1 s; FVC: Forced vital capacity; PEF: Peak expiratory flow; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; MDA: Malondialdehyde; 8-OHdG: 8-hydroxy-2’-deoxyguanosine; VAS: Visual analog scale; CI: Confidence interval.