Feasibility of non-intubated anesthesia and regional block for thoracoscopic surgery under spontaneous respiration: a prospective cohort study

Data about the feasibility and safety of thoracoscopic surgery under non-intubated anesthesia and regional block are limited. In this prospective study, 57 consecutive patients scheduled for thoracoscopic surgery were enrolled. Patients were sedated with dexmedetomidine and anesthetized with propofo...

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Bibliographic Details
Published in:Brazilian journal of medical and biological research 2020-01, Vol.53 (1), p.e8645-e8645
Main Authors: Li, Hanwei, Huang, Daiqiang, Qiao, Kun, Wang, Zheng, Xu, Shiyuan
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anesthesia
Anesthesia, General - methods
BIOLOGY
Blood pressure
Blood Pressure - drug effects
Blood Pressure - physiology
Carbon dioxide
Cohort analysis
Dexmedetomidine - administration & dosage
Feasibility Studies
Female
Health risk assessment
Heart rate
Heart Rate - drug effects
Heart Rate - physiology
Humans
Hypotension
Hypoxemia
Intubation
Lactic acid
Laryngeal Masks
Lidocaine
Male
MEDICINE, RESEARCH & EXPERIMENTAL
Middle Aged
Nerve Block - methods
Non-intubated anesthesia
Paravertebral block
Postoperative recovery
Propofol
Propofol - administration & dosage
Prospective Studies
Remifentanil
Remifentanil - administration & dosage
Respiratory tract
Ropivacaine
Spontaneous respiration
Surgery
Thoracoscopy
Thoracoscopy - methods
Vagus nerve
Young Adult
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Summary:Data about the feasibility and safety of thoracoscopic surgery under non-intubated anesthesia and regional block are limited. In this prospective study, 57 consecutive patients scheduled for thoracoscopic surgery were enrolled. Patients were sedated with dexmedetomidine and anesthetized with propofol and remifentanil. Ropivacaine was used for intercostal nerve and paravertebral block. Lidocaine was used for vagal block. The primary outcomes were mean arterial pressure (MAP), heart rate (HR), oxygen saturation, and end-tidal carbon dioxide partial pressure (ETCO2) at T0 (pre-anesthesia), T1 (immediately after laryngeal mask/nasopharyngeal airway placement), T2 (immediately after skin incision), T3 (10 min after opening the chest), T4 (end of surgery), and T5 (immediately after laryngeal mask/nasopharyngeal airway removal). One patient required conversion to intubation, 15 developed intraoperative hypotension, and two had hypoxemia. MAP at T0 and T5 was higher than at T1-T4; MAP at T3 was lower (P
ISSN:0100-879X
1414-431X
1414-431X
1678-4510
DOI:10.1590/1414-431X20198645