Comparison of laryngeal mask anesthesia and intubation anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery / 实用医学杂志

ABSTRACT

Objective To assess the feasibility of laryngeal mask anesthesia under spontaneous ventilation in pulmonary resection with uniportal video-assisted thoracoseopic.Methods Forty patients with pulmonary masses were randomized into two groups(n =20 in each group) to undergo pulmonary resection with uniportal videoassisted thoracoscopic,full implementation of thoracoscopic lobectomy and mediastinal lymph node dissection.Patients in two groups were induced by intravenous anesthesia,and the skin of the fifth intercostal space were infiltrated with ropivacaine.Patients in two both groups were maintained by intravenous ancsthesia and sevoflurane anesthesia.Muscle relaxants were administered in endotracheal inmbation group but not in the LMA group.Patients in the LMA group and tracheal intubation group underwent with spontaneous breathing and one-lung ventilation respectively.Results No significant differences were found in surgery time,intraoperative lowest SpO2,preoperative PaCO2,1-h postoperative blood gas analysis between the two groups.The anesthesia induction time,extubation time,and the stay time for the recovery of anesthesia and postoperative hospital stay were significantly shorter than those in the tracheal intubation group.The increments in MAP and HR after intubation operation were smaller than those in the LMA group.The total dosage of sulfentanyl and propofol per kg in the LMA group were significantly less than those in the control group.The PaCO2 after pulmonary resection and the intraoperative maximum level of PETCO2 in the former group were significantly higher than those in the tracheal intubation group,however the incidence of throat discomfort and the hospitalization cast were significantly decreased.Conclusion In view of patient rehabilitation and in hospitalization cast,laryngeal mask anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery was better than the procedure performed under intubation anesthesia.