Effect of anaesthesia of single chamber endotracheal intubation general anesthesia applied to thoracoscopic under carbon dioxide pneumothorax and undergone radical resection of esophageal carcinoma / 中国内镜杂志

ABSTRACT

Objective To observe the clinical responses and hemodynamic changes of single chamber endotracheal intubation general anesthesia applied to thoracoscopic resection of esophageal carcinoma under carbon dioxide pneumothorax. Method Sixty [ASA I ~ II, NYHA I ~ II, hight (148.57 ± 10.95) cm, weight (40.52 ± 3.97) kg] patients who were light weight, short height, and underwent thoracoscopic resection of esophageal carcinoma in pneumothorax with filling carbon dioxide under general anesthesia of tracheal intubation with single lumen were selected. CO2gas (6 ~ 8 L/min) was slowly inserted into the operative side thoracic cavity to maintain intrathoracic pressure 6 ~ 8 mmHg (1 mmHg=0.133 kPa), heart rate (HR), blood pressure (BP), central venous pressure (CVP), pulse oxygen saturation (SpO2), airway pressure (PaW), partial pressure of end-tidal carbon dioxide (PETCO2) and other indicators and so on, were collected at the 5 minutes before artificial pneumothora (T1), and at the 5 minutes (T2), 15 minutes(T3), 30minutes (T4), 60 minutes (T5), 100 minutes (T6) after artificial pneumothorax, and 10 minutes at the end of thoracic operation (T7), Samples of arterial blood gases were obtained at the same time. Results All cases were successfully completed by thoracoscopic surgery, significant arrhythmias and severe complications were not found at each time point; After CO2pneumothorax, HR, CVP, PaW, PETCO2and PaCO2at T2~ T6increased significantly than those at T1(P < 0.05); but BP, Arterial oxygen pressure (PaO2) and blood pH value decreased significantly at T2~ T6than those at T1(P < 0.05); SpO2at T3and T4was significantly lower than that at T1(P < 0.05), Although SpO2also decreased at T5and T6, there was no significant differences comparing to at T1(P > 0.05). After T7, most of the remaining indicators were restored to the base level excep that CVP remains high. Conclusion When patients with low weight and short stature underwent tracheal intubation under single lumen anesthesia for thoracoscopic resection of esophageal cancer under carbon dioxide pneumothorax, their hemodynamics were relatively stable,and all the indexes of respiration and arterial blood gas were within the acceptable range, It was a feasible, relatively safe method of anesthesia for such patients who could enjoy thoracoscopic techniques.