• Chiaki Murakami, Hiroaki Kawano, Michiko Kinoshita, Akio Kondo, and Masaya Inoue.
• Department of Anesthesiology, Tokushima Prefectural Central Hospital, Tokushima, Japan. Electronic address: chia.murakami@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2019 Mar 1; 33 (3): 702-709.

ObjectivesTo compare the effects of nicorandil and nitroglycerin on arterial oxygenation during two-lung ventilation (TLV) and one-lung ventilation (OLV) in patients with risk factors for myocardial ischemia.DesignA prospective, randomized, double-blind study.SettingA tertiary care hospital.ParticipantsFifty-six patients scheduled for elective video-assisted thoracic surgery were assigned randomly to either the nicorandil group or the nitroglycerin group.InterventionsPatients in the nicorandil group received a bolus dose of nicorandil, 0.08 mg/kg during induction of anesthesia, followed by a continuous infusion at a rate of 0.08 mg/kg/h. Patients in the nitroglycerin group received a continuous infusion of nitroglycerin at a rate of 1 µg/kg/min from the induction of anesthesia.Measurements And Main ResultsArterial blood gas analysis was performed at the following points: before induction of anesthesia; during TLV; at 5, 10, 20, and 30 minutes after the initiation of OLV. PaO2 at TLV (479.7 ± 57.1 v 408.2 ± 70.9 mmHg, p < 0.001); and at 5 minutes (344.8 ± 85.1 v 282.6 ± 85.8 mmHg, p = 0.012), 20 minutes (215.7 ± 103.0 v 158.2 ± 74.5 mmHg, p = 0.027), and 30 minutes (198.8 ± 103.5 v 147.5 ± 64.1 mmHg, p = 0.039) after OLV was significantly higher in the nicorandil group than in the nitroglycerin group.ConclusionThis study demonstrated that oxygenation during TLV and OLV was significantly higher in patients receiving nicorandil than in those receiving nitroglycerin.Copyright © 2018 Elsevier Inc. All rights reserved.

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