BACKGROUND: General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic pulmonary resection. We assessed in a randomized study the feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. METHODS: Between March 2001 and February 2003, 60 patients were randomized into two 30-patients arms: a general anesthesia arm entailing double-lumen intubation and thoracic epidural anesthesia (control group); and an awake arm entailing sole thoracic epidural anesthesia at T4-T5 (awake group). Anesthesia time; operative time; global operating room time; patient satisfaction with the anesthesia and technical feasibility scored into 4 grades (from 1 = poor to 4 = excellent); visual analog pain score (VAS), nursing care (number of patient calls per day), 24 hours changes in arterial oxygenation (DeltaPaO2), and hospital stay were assessed. RESULTS: There was no mortality. There was no difference in technical feasibility between the groups although 2 patients in the awake group required conversion to thoracotomy due to severe adhesions. Other 2 patients in each group required conversion due to unexpected lung cancer requiring lobectomy. Comparisons of awake versus control group results showed that in the awake group, anesthesia satisfaction score was greater (4 vs 3, p = 0.04), whereas DeltaPaO2 (-3 mm Hg vs -6.5 mm Hg, p = 0.002); nursing care (2.5 calls per day vs 4 calls per day, p = 0.0001), and hospital stay (2 days vs 3 days, p = 0.02) were significantly reduced. CONCLUSIONS: In our study, awake thoracoscopic resection of solitary pulmonary nodules proved safely feasible. It resulted in better patient satisfaction, less nursing care and shorter in-hospital stay than procedures performed under general anesthesia

Pompeo, E., Mineo, D., Rogliani, P., Sabato, A.f., Mineo, T.c. (2004). Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. ANNALS OF THORACIC SURGERY, 78(5), 1761-1768 [10.1016/j.athoracsur.2004.05.083].

Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules

POMPEO, EUGENIO;MINEO, DAVIDE;ROGLIANI, PAOLA;SABATO, ALESSANDRO FABRIZIO;MINEO, TOMMASO CLAUDIO
2004-11-01

Abstract

BACKGROUND: General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic pulmonary resection. We assessed in a randomized study the feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. METHODS: Between March 2001 and February 2003, 60 patients were randomized into two 30-patients arms: a general anesthesia arm entailing double-lumen intubation and thoracic epidural anesthesia (control group); and an awake arm entailing sole thoracic epidural anesthesia at T4-T5 (awake group). Anesthesia time; operative time; global operating room time; patient satisfaction with the anesthesia and technical feasibility scored into 4 grades (from 1 = poor to 4 = excellent); visual analog pain score (VAS), nursing care (number of patient calls per day), 24 hours changes in arterial oxygenation (DeltaPaO2), and hospital stay were assessed. RESULTS: There was no mortality. There was no difference in technical feasibility between the groups although 2 patients in the awake group required conversion to thoracotomy due to severe adhesions. Other 2 patients in each group required conversion due to unexpected lung cancer requiring lobectomy. Comparisons of awake versus control group results showed that in the awake group, anesthesia satisfaction score was greater (4 vs 3, p = 0.04), whereas DeltaPaO2 (-3 mm Hg vs -6.5 mm Hg, p = 0.002); nursing care (2.5 calls per day vs 4 calls per day, p = 0.0001), and hospital stay (2 days vs 3 days, p = 0.02) were significantly reduced. CONCLUSIONS: In our study, awake thoracoscopic resection of solitary pulmonary nodules proved safely feasible. It resulted in better patient satisfaction, less nursing care and shorter in-hospital stay than procedures performed under general anesthesia
nov-2004
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO
Settore MED/41 - ANESTESIOLOGIA
English
Con Impact Factor ISI
Patient Satisfaction; Humans; Anesthesia, General; Respiration, Artificial; Aged; Solitary Pulmonary Nodule; Thoracic Surgery, Video-Assisted; Anoxia; Feasibility Studies; Pneumonectomy; Postoperative Complications; Length of Stay; Lung Neoplasms; Anesthesia, Epidural; Treatment Outcome; Middle Aged; Wakefulness; Female; Male; Pain, Postoperative
Pompeo, E., Mineo, D., Rogliani, P., Sabato, A.f., Mineo, T.c. (2004). Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. ANNALS OF THORACIC SURGERY, 78(5), 1761-1768 [10.1016/j.athoracsur.2004.05.083].
Pompeo, E; Mineo, D; Rogliani, P; Sabato, Af; Mineo, Tc
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/35406
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