Research On Application Of Non-intubated Anesthesia In Video-assisted Thoracoscopic Surgery

Objective: To comparative analyze the feasibility and advantages of non-intubated anesthesia in thoracoscopic lobectomy.Methods: A retrospective analysis was made from January 2015 to December 2017,which elected cases data of non-intubation thoracoscope lung resection and the endotracheal intubation anesthesia thoracoscope lung resection in the department of thoracic surgery,Wu Han Tong Ji Hospital,within the three years,Complications in the airway injury,atelectasis,pulmonary infection,refractory cough,pharyngalgia,nausea and vomiting were compared between the two groups.Postoperative inflammatory factor levels,the retain time of thoracic duct,The utility time of antibiotics,postoperative hospitalization days,and intraoperative and postoperative hospitalization costs were also in the conparisons.Results:There was no difference between the two groups in general conditions such as age,gender,BMI index.There was no difference in operation time,intraoperative bleeding volume and lymph node dissection.But the observation group has obvious advantages in inflammatory factor levels,postoperative complications,the retain time of thoracic duct,The utility time of antibiotics,postoperative hospitalization days,and intraoperative and postoperative hospitalization costs.Conclusion: Non-intubated anesthesia thoracoscopic lobectomy can avoid traditional airway injury caused by endotracheal intubation,reduce postoperative symptoms such as refractory cough,pharyngalgia,nausea and vomiting caused by general anesthesia,reduce or even avoid lung injury caused by one-side lung ventilation,promote ERAS,reduce antibiotic use,and shorten hospitalization time,which is more consistent with the requirements of the concept of overall minimally invasive and enhanced recovery.Objective: To comparative analyze the feasibility and advantages of non-intubated anesthesia in the anterior mediastinal tumor resection with subxiphoid thoracoscopy.Methods: A retrospective analysis was made from January 2015 to December 2017,which elected cases data of non-intubation subxiphoid thoracoscopic thymectomy in the department of thoracic surgery,Wu Han Tong Ji Hospital,within the three years,as a observation group.And a total of 41 cases of total thymectomy were performed in the double-lumen tracheal intubation in the same period,as a control group.Compare differences between two groups in operative time,intraoperative blood loss,whether merger vascular injury and awakening time,postoperative inflammatory factor levels,postoperative pain score,postoperative hospitalization days,etc.Results:There was no difference between the two groups in general conditions such as age,gender,BMI index.There was no difference in intraoperative hemorrhage and vascular injury.The observation group had shorter operative and awakening time.There were more advantages in inflammatory factor level,postoperative pain,postoperative hospitalization days,etc..Conclusion: Non-intubated anesthesia can be used in the anterior mediastinal tumor resection with subxiphoid thoracoscopy.Can effectively reduce surgery and anesthesia trauma,shorten the awakening tim,reduce the postoperative incidence,shorten postoperative hospital stay,reduce hospital costs.More consistent with the concept of rapid rehabilitation..Objective: Report 1 case of non-intubated anesthesia complete laparoscopic esophageal cancer resection,analyze its advantages and explore the feasibility of the application.Methods: Collect 1 case of non-intubated anesthesia complete laparoscopic esophageal cancer resection the wuhan tongji hospital thoracic surgery in the department of thoracic surgery,Wu Han Tong Ji Hospital.Describe the specific implementation in detail,analyze intraoperative indicators and postoperative recovery.Results:The patient recovered rapidly,without the symptoms such as phlegm,dyspnea,vomiting,abdominal distension.The time of eating,extubation,and discharge time is early than conventional esophageal cancer resection.Conclusion: The non-intubated anesthesia complete laparoscopic esophageal cancer resection can avoid airway injury caused by endotracheal intubation,reduce ventilator-induced lung injury,promote rapid recovery.It is safe and feasible to switch between automatic breathing and mechanical ventilation under the application of the laryngeal mask.