单位：[a]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China,临床科室麻醉科麻醉科首都医科大学附属北京友谊医院[b]Psychology, Indiana University Bloomington, Bloomington, Indiana, USA,[c]Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.临床科室胸外科胸外科首都医科大学附属北京友谊医院
General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB). From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed. The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0,P = .024 andP = .006, respectively). No differences were seen in PaO(2)values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40,P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33,P = .014) in the study group than in the control group. The PaCO(2)value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg,P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases. Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.
第一作者单位：[a]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China,
通讯作者：
通讯机构：[c]Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.[*1]Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’ an Road, Xicheng District, Beijing 100050, China
推荐引用方式(GB/T 7714)：
Li Xiu-Liang,He Xiang-Bo,Wan Lei,et al.Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy[J].MEDICINE.2020,99(16):doi:10.1097/MD.0000000000019704.
APA：
Li, Xiu-Liang,He, Xiang-Bo,Wan, Lei,Liu, Chun-Quan&Cui, Yong.(2020).Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy.MEDICINE,99,(16)
MLA：
Li, Xiu-Liang,et al."Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy".MEDICINE 99..16(2020)
