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

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

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

Results: 147 lymphangiograms from 141 patients, median age 64 years [56-72 years IQR] were reviewed. Sedation (vs. general anesthesia) was associated with 43% shorter log-transformed contrast transit time (βˆ=1.43, 95% CI 1.04-1.97, P=0.029), reflecting a 13-minute faster median contrast transit time (ASD 0.44). Vasoconstrictor administration was not associated with contrast transit time (bolus administration: βˆ=0.79, 95% CI 0.53-1.18, P=0.251; infusion and bolus administration: βˆ=0.89, 95% CI 0.63-1.25, P=0.495). In addition to its association with increased contrast transit time, general anesthesia also added a median of 16 [11.0 - 22.3] minutes of anesthesiology care time to cases.

Conclusions: Sedation (vs. general anesthesia), but not vasoconstrictor administration, was associated with shorter contrast 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.