ABSTRACT
Objective To explore the feasibility and safety of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration.Methods The clinical data in 35 cases of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration implemented by same doctor and team in the Affiliated Nanjing Chest Hospital of Medical College,Southeast University from June 2016 to January 2017 were retrospectively analyzed.Results The operations were successfully completed in 35 cases,including 23 cases of lung bullae resection,6 cases of lung wedge resection,5 cases of pulmonary lobectomy and lymph nodes clearance,and 1 case of bilateral sympathectomy.The operative time was 20-106min,average(38.79 ± 26.45) min,intraoperative bleeding volume was 20-350 mL,average(57.14 ± 56.50) mL.No perioperative serious complications or death occurred.Conclusion Uniportal video-assisted thoracoscopic surgery technique under non-intubated anesthesia with spontaneous respiration is safe and feasible,and can be selectively used in partial patients.
ABSTRACT
Objective To evaluate the anesthetic effect of ultrasound guided thoracic paraverte-bral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy. Methods Eighty patients (38 male and 42 female ) undergoing selected thoracoscopic sympathectomy,aged from 16 to 28 years,in ASA physical status Ⅰ or Ⅱ,were equally divided into study group and control group,40 patients in each,according to random number table.Fifteen mi-nutes before paravertebral blockade,while study group received loading dose (0.5 μg/kg)of dexme-detomidine (4 μg/ml)intravenously within 10 min and received continuous intravenous pumping (0.3-0.5 μg·kg-1·h-1 )throughout the operation,control group received isovolumetric normal saline in the same pattern.Patients'heart rate (HR),respiratory rate (RR),mean arterial pressure (MAP),SpO 2 ,observer's assessment of alertness/sedation (OAA/S)scale and adverse reactions were recorded in several time points,namely timing of entrance (T0 ),timing of paravertebral block-ade (T1 ),timing of skin incision (T2 ),timing of sympathectomy (T3 )and the end (T4 ),respective-ly.Results Compared to the control group,while MAP and HR in the study group were obviously decreased through T1-T4 (P <0.05),RR was obvious increased in T2 and T3 (P <0.05)and OAA/S scale was obviously lowered in the study group (P <0.05 ).The study group and the control group had one case and two cases of adverse reaction,respectively,with no significant difference between the two groups.Conclusion The application of ultrasound guided thoracic paravertebral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy is safe and effective.