Intubated Versus Nonintubated General Anesthesia for Video-Assisted Thoracoscopic Surgery-A Case-Control Study.
J Cardiothorac Vasc Anesth
; 31(2): 411-417, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-27692903
ABSTRACT
OBJECTIVE:
General anesthesia with endobronchial intubation and one-lung positive-pressure ventilation always has been considered mandatory for thoracic surgery. Recently, there has been interest in nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients. The authors' center developed a nonintubated technique with spontaneous ventilation with the patient under general anesthesia using a supraglottic airway device. The authors believe that this was the first study to compare a nonintubated general anesthetic technique with an intubated general anesthetic technique for VATS.DESIGN:
Retrospective, observational study.SETTING:
Specialist cardiothoracic hospital in the United Kingdom.PARTICIPANTS:
All patients who underwent elective minor VATS over 8 months (n = 73).INTERVENTIONS:
A nonintubated general anesthetic technique with spontaneous ventilation via a supraglottic airway device was used for minor VATS procedures. This was compared with a case-matched intubated group. MEASUREMENTS AND MAINRESULTS:
Both groups had comparable baseline characteristics and surgical procedures. The anesthetic time was shorter in the nonintubated group (13.6±8.3 v 24.1±10.9 minutes, p<0.001). Surgical operating time and feasibility were similar. Intraoperatively, there were increases in end-tidal carbon dioxide (59.1±12.9 v 41.8±4.6, p<0.001) and respiratory rate (17.8±5.6 v 13.5±2.0, p<0.001) in the nonintubated group. Fewer patients in the nonintubated group had moderate-severe pain during recovery (19.4% v 48.4%, p = 0.02) and pain on discharge to the ward (25.8% v 61.3%, p = 0.004). There was a trend toward shorter recovery times, reduced oxygen requirement, and shorter hospital stays in the nonintubated group.CONCLUSIONS:
A nonintubated general anesthetic technique is a feasible alternative to intubated general anesthesia for minor VATS procedures.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cirurgia Torácica Vídeoassistida
/
Intubação Intratraqueal
/
Anestesia Geral
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article