Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period

Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min

Research output: Contribution to journalArticle

Abstract

Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study. Twenty-one patients were under sedation anesthesia (SA group) and 20 patients were under general anesthesia (GA group). In SA group, sedation was done with dexmedetomidine (a loading dose of 1 μg/kg for 10 min and then maintained in dosages of 0.3-1 μg/kg/h) and ketamine (2-4 mg/kg/h intraoperatively). Meanwhile, in GA group, induction with propofol and rocuronium, intubation with double lumen endotracheal tube and maintenance with 1.0-2.5% sevoflurane was done. In both groups, thoracoscopic bullectomy was performed in the same manner and all operations were conducted by single surgeon. Time for anesthesia [including emergence time and post-anesthesia care unit (PACU) recovery time] and operation, postoperative pain, sore throat, hoarseness, adverse events (nausea, vomiting, hypotension and bradycardia), dose of rescue analgesic drug used for 24 hours post-operatively and perioperative arterial blood gas analysis were recorded. Results: The times for anesthesia, operation and emergence were significantly shorter in SA than GA. Incidence of sore throat were significantly lower in SA. The difference of other adverse events in the two groups was not significant. Conclusions: Our study demonstrated that compared to double-lumen intubation with general anesthesia, non-intubation with sedation for bullectomy for primary spontaneous pneumothorax was safe and efficient to reduce perioperative time.

Original languageEnglish
Pages (from-to)1703-1710
Number of pages8
JournalJournal of Thoracic Disease
Volume10
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

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Perioperative Period
Intubation
Anesthesia
General Anesthesia
Thoracoscopy
Pharyngitis
Pneumothorax
Dexmedetomidine
Hoarseness
Blood Gas Analysis
Conduction Anesthesia
Ketamine
Propofol
Bradycardia
Postoperative Pain
Artificial Respiration
Hypotension
Nausea
Vomiting
Analgesics

Keywords

  • Bullectomy
  • Dexmedetomidine
  • Ketamine
  • Non-intubated thoracoscopic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period. / Hwang, Jinwook; Shin, Jae Seung; Son, Joo Hyung; Min, Too Jae.

In: Journal of Thoracic Disease, Vol. 10, No. 3, 01.03.2018, p. 1703-1710.

Research output: Contribution to journalArticle

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