PMID- 38475699
OWN - NLM
STAT- MEDLINE
DCOM- 20240314
LR  - 20240315
IS  - 1471-2253 (Electronic)
IS  - 1471-2253 (Linking)
VI  - 24
IP  - 1
DP  - 2024 Mar 12
TI  - Nonintubated spontaneous ventilation versus intubated mechanical ventilation 
      anesthesia for video-assisted thoracic surgery in terms of perioperative 
      complications and practitioners' workload assessments: a pilot randomized control 
      study.
PG  - 99
LID - 10.1186/s12871-024-02481-1 [doi]
LID - 99
AB  - BACKGROUND: The use of nonintubated video-assisted thoracoscopic surgery 
      (NI-VATS) has been increasingly reported to yield favourable outcomes. However, 
      this technology has not been routinely used because its advantages and safety 
      have not been fully confirmed. The aim of this study was to assess the safety and 
      feasibility of nonintubated spontaneous ventilation (NI-SV) anesthesia compared 
      to intubated mechanical ventilation (I-MV) anesthesia in VATS by evaluating of 
      perioperative complications and practitioners' workloads. METHODS: Patients who 
      underwent uniportal VATS were randomly assigned at a 1:1 ratio to receive NI-SV 
      or I-MV anesthesia. The primary outcome was the occurrence of intraoperative 
      airway intervention events, including transient MV, conversion to intubation and 
      repositioning of the double-lumen tube. The secondary outcomes included 
      perioperative complications and modified National Aeronautics and Space 
      Administration Task Load Index (NASA-TLX) scores from anesthesiologists and 
      surgeons. RESULTS: Thirty-five patients in each group were enrolled in the 
      intention-to-treat analysis. The incidence of intraoperative airway intervention 
      events was greater in the NI-SV group than in the I-MV group (12 [34.3%] vs. 3 
      [8.6%]; OR = 0.180; 95% CI = 0.045-0.710; p = 0.009). No significant difference 
      was found in the postoperative pulmonary complications between the groups 
      (p > 0.05). The median of the anesthesiologists' overall NASA-TLX score was 37.5 
      (29-52) when administering the NI-SV, which was greater than the 25 (19-34.5) 
      when the I-MV was administered (p < 0.001). The surgeons' overall NASA-TLX score 
      was comparable between the two ventilation strategies (28 [21-38.5] vs. 27 
      [20.5-38.5], p = 0.814). CONCLUSION: The NI-SV anesthesia was feasible for VATS 
      in the selected patients, with a greater incidence of intraoperative airway 
      intervention events than I-MV anesthesia, and with more surgical effort required 
      by anesthesiologists. TRIAL REGISTRATION: Chinese Clinical Trial Registry, 
      ChiCTR2200055427. https://www.chictr.org.cn/showproj.html?proj=147872 was 
      registered on January 09, 2022.
CI  - (c) 2024. The Author(s).
FAU - Kong, Xian-Gang
AU  - Kong XG
AD  - Department of Anesthesiology, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Wang, Kun
AU  - Wang K
AD  - Department of Anesthesiology, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Wei, Yu-Tao
AU  - Wei YT
AD  - Department of Thoracic Surgery, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Sun, Bo
AU  - Sun B
AD  - Department of Thoracic Surgery, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Gao, Guo-Dong
AU  - Gao GD
AD  - Department of Thoracic Surgery, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Song, Cheng-Wei
AU  - Song CW
AD  - Department of Anesthesiology, Jining No. 1 People's Hospital, No. 6 Jiankang 
      Road, Rencheng District, Jining, 272011, China.
FAU - Li, Cheng-Wen
AU  - Li CW
AD  - Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical 
      University, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China. 
      lichwen2008@126.com.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20240312
PL  - England
TA  - BMC Anesthesiol
JT  - BMC anesthesiology
JID - 100968535
SB  - IM
MH  - Humans
MH  - *Thoracic Surgery, Video-Assisted
MH  - Respiration, Artificial/adverse effects
MH  - Workload
MH  - Pilot Projects
MH  - *Anesthesia/adverse effects
MH  - Postoperative Complications/epidemiology
PMC - PMC10929236
OTO - NOTNLM
OT  - Intubation
OT  - Mechanical ventilation
OT  - Nonintubated
OT  - Spontaneous ventilation
OT  - Video-assisted thoracoscopic surgery
COIS- The authors declare no competing interests.
EDAT- 2024/03/13 06:46
MHDA- 2024/03/14 06:46
PMCR- 2024/03/12
CRDT- 2024/03/13 02:18
PHST- 2023/06/30 00:00 [received]
PHST- 2024/03/04 00:00 [accepted]
PHST- 2024/03/14 06:46 [medline]
PHST- 2024/03/13 06:46 [pubmed]
PHST- 2024/03/13 02:18 [entrez]
PHST- 2024/03/12 00:00 [pmc-release]
AID - 10.1186/s12871-024-02481-1 [pii]
AID - 2481 [pii]
AID - 10.1186/s12871-024-02481-1 [doi]
PST - epublish
SO  - BMC Anesthesiol. 2024 Mar 12;24(1):99. doi: 10.1186/s12871-024-02481-1.