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11 November 2018 : Clinical Research  

A Propensity Score-Matched Analysis for Non-Intubated Thoracic Surgery

Lan Lan1ABE*, Yanyi Cen1CD, Canzhou Zhang1BF, Yuan Qiu23B, Baoyi Ouyang1D

DOI: 10.12659/MSM.910605

Med Sci Monit 2018; 24: CLR8081-8087

Abstract

BACKGROUND: Most observations of non-intubated anesthesia under spontaneous breathing are small-cohort, non-homogeneous surgery types and lack an intubation control. We therefore retrospectively compared the perioperative conditions and postoperative recovery of non-intubated video-assisted thoracoscopic surgery (NIVATS group) and intubated VATS (IVATS group) with a propensity score-matching analysis.

MATERIAL AND METHODS: We case-matched 119 patients in the NIVATS group with patients in the IVATS group by a propensity score-matched analysis. All of them underwent lobectomy.

RESULTS: In the NIVATS group, operative and anesthesia times were significantly shorter (P<0.01). NIVATS showed a faster and more stable recovery in the PACU, postoperative awaking and post-anesthesia care unit (PACU) stay times was shorter (P<0.01), and use of sedatives and analgesics was lower (P<0.05). The incidence of pulmonary exudation, atelectasis, and pleural effusion were higher (P<0.05). Although intraoperative SpO2 was lower and PETCO2 was higher in the NIVATS group (P<0.01), postoperative PaCO2 and SaO2 in both groups were similar (P>0.05). Postoperative counts of leukocytes and neutrophils and hemoglobin levels also had no difference between the 2 groups (P>0.05).

CONCLUSIONS: NIVATS has a more rapid and stable recovery in the PACU, and has no significant influence on oxygenation, but is more likely to cause postoperative radiologic complications.

Keywords: Intubation, Intratracheal, Postanesthesia Nursing, Thoracic Surgery, Video-Assisted

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750