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Medical Science Monitor Basic Research


eISSN: 1643-3750

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

Lan Lan, Yanyi Cen, Canzhou Zhang, Yuan Qiu, Baoyi Ouyang

Department of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)

Med Sci Monit 2018; 24: CLR8081-8087

DOI: 10.12659/MSM.910605

Available online: 2018-11-11

Published: 2018-11-11


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