Association of Anesthesia Type and Vasoconstrictor Use with Intranodal Lymphangiography Duration: A Multicenter Retrospective Cohort Study.

Abstract

Purpose: To investigate whether anesthesia type (sedation vs general anesthesia [GA]) or α₁-adrenergic agonist vasoconstrictor administration is associated with faster intralymphatic contrast agent transit during intranodal lymphangiography in an effort to identify modifiable nonprocedural factors that may reduce procedure duration.

Materials and methods: This retrospective observational study reviewed intranodal lymphangiography from 2 academic hospitals (2015-2022). A multiple linear regression model assessed the association of anesthesia type and vasoconstrictor administration with intralymphatic contrast agent transit time, controlled for confounders.

Results: A total of 147 lymphangiograms from 141 patients (median age, 64 years [interquartile range, 56-72 years]) were reviewed. Sedation (vs GA) was associated with 43% shorter log-transformed contrast agent transit time (βˆ = 1.43; 95% CI, 1.04-1.97; P = .029), reflecting a 13-minute faster median contrast agent transit time (absolute standardized difference, 0.44). Vasoconstrictor administration was not associated with contrast agent transit time (bolus administration, βˆ = 0.79 [95% CI, 0.53-1.18; P = .251]; infusion and bolus administration, βˆ = 0.89 [95% CI, 0.63-1.25; P = .495]). In addition to its association with increased contrast agent transit time, GA also added a median of 16 minutes (range, 11.0-22.3 minutes) of anesthesiology care time to cases.

Conclusions: Sedation (vs GA), but not vasoconstrictor administration, was associated with shorter contrast agent transit time and anesthesiology care time. This proof-of-concept clinical evidence that anesthesia may modulate lymphatic function sheds light on the lymphatic system as a collateral pharmacologic target of anesthetics.