Application of non-endotracheal intubation anesthesia under self-sustaining breathing in pulmonary herpes resection in patients over 45 years old

doi:10.3877/cma.j.issn.2095-8757.2019.03.008

Abstract

Abstract:

Objective

To explore the clinical effect and safety of the non-intubated anaesthetic in patients over 45 years old.

Methods

From February 2017 to February 2018, 30 patients over 45 years old admitted to Zhejiang Hospital were selected. Among them, 17 patients were treated with endotracheal intubation anesthesia (group A) and 13 patients with non-endotracheal intubation anesthesia (group B). The operation time, postoperative pain score, postoperative feeding time, postoperative out-of-bed activity time, extubation time and total hospitalization time were observed and compared between the two groups. T test was used to compare the measurement data between the two groups, and χ² test was used to compare the count data.

Results

All operations were completed successfully, and there was no transference intubation in group A, no conversion to thoracotomy and no postoperative complications. The operation time of group A was longer than that of group B (t=-1.751, P<0.05), the feeding time and underground activity time were significantly shorter than that in group B (t=9.995, 7.256, P<0.05). There was no significant difference in pain score, extubation time and hospitalization time between group A and group B (t=3.009, 2.314, 2.992, P>0.05).

Conclusion

For middle-aged and elderly patients undergoing thoracoscopic bullosa removal, it has the advantages of fast recovery, high satisfaction and little pain to keep the self breathing and non endotracheal intubation anesthesia. Under the premise of strict indications and standardized operation, the anesthesia is safe and feasible.

Key words: Middle-aged and aged, Non-tracheal intubation, Video-assisted-thoracoscopic surgery, Spontaneous pneumothorax

Lei Zhang, Xinhai Zhu, Yanfei Xia. Application of non-endotracheal intubation anesthesia under self-sustaining breathing in pulmonary herpes resection in patients over 45 years old[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2019, 06(03): 29-33.

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References 18

[1]	Shaikhrezai K, Thompson AI, Parkin C, et al. Video-assisted thoracoscopic surgery management of spontaneous pneumothorax-long-term results[J]. Eur J Cardiothorac Surg, 2011, 40(1):120-123.
[2]	杨震，闫天生，贺未.自发性气胸电视胸腔镜术后复发的相关预后因素研究现状[J].中国微创外科杂志，2017，17（5）：461-465.
[3]	李田，梅新宇，解明然，等.单操作孔电视胸腔镜肺大疱切除术的临床应用[J].安徽医科大学学报，2016，51（5）：699-702.
[4]	史经伟，杨如松，邵丰，等.非气管插管保留自主呼吸麻醉下单孔胸腔镜技术的临床应用[J].重庆医学，2018，47（4）：480-485.
[5]	Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution[J]. J Thorac Dis, 2012, 4(4):347-351.
[6]	Sunaga H, Blasberg JD, Heerdt PM. Anesthesia for nonintubated video-assisted thoracic surgery[J]. Curr Opin Anaesthesiol, 2017, 30(1):1-6.
[7]	Wilson M, Stacey S, Anwar S. Intubated versus nonintubated general anesthesia for video-assisted thoracoscopic surgery - a case control study: a response[J]. J Cardiothorac Vasc Anesth, 2018, 32(1):32-33.
[8]	张洪江，潘维敏，张林，等.喉罩全麻和气管插管全麻在单孔胸腔镜肺叶切除术中的临床对照研究[J].实用医学杂志，2017，33（3）：455-458.
[9]	崔飞，刘君，陈汉章，等.自主呼吸非气管插管硬膜外麻醉胸腔镜手术511例[J].中华生物医学工程杂志，2016，22（4）：328-332.
[10]	Guo Z, Shao W, Yin W, et al. Analysis of feasibility and safety of complete video-assisted thoracoscopic resection of anatomic pulmonary segments under non-intubated anesthesia[J]. J Thorac Dis, 2014, 6(1):37-44.
[11]	Gelzinis TA, Sullivan EA. Non-intubated general anesthesia for video-assisted thoracoscopic surgery[J]. J Cardiothorac Vasc Anesth, 2017, 31(2):407-408.
[12]	李诗恩，胡安民，张中军.保留自主呼吸非插管麻醉在胸腔镜手术中的应用进展[J].医学综述，2017，23（20）：4132-4136.
[13]	Deng HY, Zhu ZJ, Wang YC, et al. Non-intubated video-assisted thoracoscopic surgery under loco-regional anaesthesia for thoracic surgery: a meta-analysis[J]. Interact Cardiovasc Thorac Surg, 2016, 23(1):31-40.
[14]	李向楠，潘雪，赵松，等.保留自主呼吸在胸腔镜手术中的应用[J].中华实验外科杂志，2014，31（2）：450.
[15]	张继琛，娄凯，杨泽山，等.气管插管与非气管插管在胸腔镜肺癌手术中临床效果比较[J].中国现代医生，2017，55（21）：49-52.
[16]	Navarro-Martínez J, Gálvez C, Rivera-Cogollos MJ, et al. Intraoperative crisis resource management during a non-intubated video-assisted thoracoscopic surgery[J]. Ann Transl Med, 2015, 3(8):111.
[17]	杨田军，刘宝.允许性高碳酸血症对呼吸循环系统的影响[J].国际呼吸杂志，2011，31（2）：151-154.
[18]	Chen JS, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lobectomy for lung cancer[J]. Annals of Surgery, 2011, 6(6):1038-1043.

组别	例数	性别（男/女，例）	年龄（岁）	发病部位（左胸/右胸，例）
气管插管麻醉组	17	16/1	45～70（60.47±7.73）	14/3
非气管插管麻醉组	13	11/2	45～72（55.46±8.48）	11/2
检验值	?	χ²=0.739	t=1.687	χ²=0.027
P值	?	>0.05	>0.05	>0.05

组别	例数	性别（男/女，例）	年龄（岁）	发病部位（左胸/右胸，例）
气管插管麻醉组	17	16/1	45～70（60.47±7.73）	14/3
非气管插管麻醉组	13	11/2	45～72（55.46±8.48）	11/2
检验值	?	χ²=0.739	t=1.687	χ²=0.027
P值	?	>0.05	>0.05	>0.05

组别	例数	手术时间（min）	术后疼痛评分（分）	进食时间（h）	下床活动时间（h）	拔管时间（d）	住院时间（d）
气管插管麻醉组	17	93.41±6.58	3.35±0.78	11.82±1.38	10.53±1.18	4.35±0.99	11.94±2.19
非气管插管麻醉组	13	99.15±11.26	2.54±0.66	7.69±0.63	6.38±1.94	3.62±0.65	9.92±1.18
t值	?	-1.751	3.009	9.995	7.256	2.314	2.992
P值	?	<0.05	>0.05	<0.05	<0.05	>0.05	>0.05

组别	例数	手术时间（min）	术后疼痛评分（分）	进食时间（h）	下床活动时间（h）	拔管时间（d）	住院时间（d）
气管插管麻醉组	17	93.41±6.58	3.35±0.78	11.82±1.38	10.53±1.18	4.35±0.99	11.94±2.19
非气管插管麻醉组	13	99.15±11.26	2.54±0.66	7.69±0.63	6.38±1.94	3.62±0.65	9.92±1.18
t值	?	-1.751	3.009	9.995	7.256	2.314	2.992
P值	?	<0.05	>0.05	<0.05	<0.05	>0.05	>0.05

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