Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study

BMC Anesthesiology

Research

Wen-Kuei Chang¹  Fu-Kai Hsu¹  Wei-Nung Teng¹  Hung-Wei Cheng²  Chien‑Kun Ting³  Po-Kuei Hsu⁴  Han-Shui Hsu⁴ 

[1] Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Rd, 11217, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Rd, 11217, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan, ROC;Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Rd, 11217, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, 112304, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Surgery, Division of Thoracic Surgery, Taipei Veterans General Hospital, Taipei, Taiwan;

关键词: Anesthesia;    Postoperative pulmonary complications;    Lung resection surgery;    Volatile anesthesia;    Total intravenous anesthesia;   

DOI  :  10.1186/s12871-023-02260-4

 received in 2023-05-08, accepted in 2023-08-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is no consensus regarding the superiority of volatile or total intravenous anesthesia (TIVA) in reducing the incidence of postoperative pulmonary complications (PPCs) after lung resection surgery (LRS). Thus, the aim of this study was to investigate the different anesthetic regimens and the incidence of PPCs in patients who underwent LRS. We hypothesized that TIVA is associated with a lower incidence of PPCs than volatile anesthesia.MethodsThis was a retrospective cohort study of patients who underwent LRS at Taipei Veterans General Hospital between January 2016 and December 2020. The patients’ charts were reviewed and data on patient characteristics, perioperative features, and postoperative outcomes were extracted and analyzed. The patients were categorized into TIVA or volatile anesthesia groups and their clinical data were compared. Propensity score matching was performed to reduce potential selection bias. The primary outcome was the incidence of PPCs, whereas the secondary outcomes were the incidences of other postoperative events, such as length of hospital stay (LOS) and postoperative nausea and vomiting (PONV).ResultsA total of 392 patients each were included in the TIVA and volatile anesthesia groups. There was no statistically significant difference in the incidence of PPCs between the volatile anesthesia and TIVA groups. The TIVA group had a shorter LOS (p < 0.001) and a lower incidence of PONV than the volatile anesthesia group (4.6% in the TIVA group vs. 8.2% in the volatile anesthesia group; p = 0.041). However, there were no significant differences in reintubation, 30-day readmission, and re-operation rates between the two groups.ConclusionsThere was no significant difference between the incidence of PPCs in patients who underwent LRS under TIVA and that in patients who underwent LRS under volatile anesthesia. However, TIVA had shorter LOS and lower incidence of PONV which may be a better choice for maintenance of anesthesia in patients undergoing LRS.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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