Keimyung Med J.  2019 Dec;38(1,2):39-44. 10.0000/kmj.2019.38.1.39.

Comparison of Outcomes between Intubated and Non-intubated Video-assisted Thoracoscopic Wedge Resections Applied in the Same Patient

• Han I
• Lee AR
• Park SE
• Lee HK
• Park ES

• KMID: 2469576
• DOI: http://doi.org/10.0000/kmj.2019.38.1.39

Abstract

In video-assisted thoracoscopic surgery (VATS), general anesthesia with endotracheal intubation was considered an optimal method of anesthesia for a long time. However, complications due to general anesthesia and one-lung ventilation have become a problem. In recent years, epidural anesthesia without endotracheal intubation has been attempted in various thoracic surgical procedures with various advantages and disadvantages reported. We compared postoperative pain and prognosis when different anesthesia methods were used in a patient who underwent the same operation twice in the interval of one year. When non-intubated video-assisted thoracoscopic surgery (NIVATS) underwent under epidural anesthesia, postoperative pain score was lower, adverse events were fewer, and the hospital stay was shorter than that of VATS. The patient also expressed high subjective satisfaction. Like previous studies, the results favored NIVATS under epidural anesthesia. However, greater attention and proficiency are required from the anesthesiologist for proper analgesia and sedation.

Keyword

Epidural anesthesia; Intubation; Non-intubated thoracoscopic surgery; Video assisted thoracoscopic surgery

MeSH Terms

Analgesia
Anesthesia
Anesthesia, Epidural
Anesthesia, General
Humans
Intubation
Intubation, Intratracheal
Length of Stay
Methods
One-Lung Ventilation
Pain, Postoperative
Prognosis
Thoracic Surgery, Video-Assisted
Thoracic Surgical Procedures