Clinical Comparative Study Of General Anesthesia With Laryngeal Mask Airway And Double Lumen Endotracheal Intubation In Thoracoscopic Lobectomy

Objective: To investigate the safety and feasibility of general anesthesia with self breathing laryngeal mask in thoracoscopic lobectomy by comparing the related indexes of general anesthesia with self breathing laryngeal mask and double lumen endotracheal intubation during and after thoracoscopic lobectomy.Methods: From December 2019 to January 2021,60 patients with pulmonary masses diagnosed before operation in our hospital were randomly divided into experimental group and control group,30 cases in each group.full implementation of thoracoscopic lobectomy and mediastinal lymph node dissection.In the experimental group,muscle relaxant was not used,while laryngeal mask airway was inserted to keep spontaneous breathing.In the control group,muscle relaxant was used,double lumen bronchial catheter was inserted,and one lung ventilation was performed.The operation time,intraoperative blood loss,satisfaction with operation vision,conversion to thoracotomy,postoperative hospital stay,total cost,postoperative extubation time,Pa CO2 before and after operation,postoperative gastrointestinal reactions,sore throat,hoarseness,pulmonary infection and other adverse reactions were recorded and compared between the two groups,as well as the24-hour visual analogue scale(VAS)scoreResults:The length of hospital stay,the total cost of hospitalization,the incidence of gastrointestinal reactions and sore throat in the experimental group were significantly lower than those in the control group(P<0.05);There was no significant difference in operation time,intraoperative blood loss,satisfaction with operation field,extubation time,24-hour postoperative pain score,incidence of Pa CO2 hoarseness and pulmonary infection between the two groups(P > 0.05)Conclusions:1.The application of laryngeal mask general anesthesia with self breathing in thoracoscopic lobectomy is feasible.2.Compared with double lumen endotracheal intubation anesthesia,laryngeal mask airway general anesthesia with self breathing has more advantages in postoperative hospitalization days,total cost of hospitalization,incidence of gastrointestinal tract and sore throat.3.Two groups of patients in intraoperative blood loss,operation time,conversion to thoracotomy,surgical field satisfaction,postoperative extubation time,postoperative 24 h VAS score,before and after Pa CO2,the incidence of hoarseness and the incidence of pulmonary infection and other aspects of the effect is similar,with good clinical application effect.