Journal of Chest Surgery

  • 제55권1호
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  • Pages.30-36
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  • 2022
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Effects of Inhalation versus Total Intravenous Anesthesia on Postoperative Pulmonary Complications after Anatomic Pulmonary Resection

  • Lee, Soojin (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Cho, Jeong Su (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Eunsoo (Department of Anesthesia and Pain Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Yeongdae (Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Jonggeun (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine)
  • 투고 : 2021.09.29
  • 심사 : 2021.11.09
  • 발행 : 2022.02.05
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초록

Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

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과제정보

This work was supported by a clinical research grant from Pusan National University Hospital in 2021.

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