Cost-effectiveness of different methods of anesthesia for thoracoscopic bulla resection:non-intubated and conventional general anesthesia

XU Qingrong; SHEN Jiang; WU Yuehong; JIANG Bo; ZHANG Lei

doi:10.3969/j.issn.1006-5725.2019.03.019

Abstract：Objective To compare the cost-effectiveness of non-intubated general anesthesia with conventional general anesthesia for thoracoscopic bulla resection. Methods Sixty patients scheduled for elective thoracoscopic bulla resection, were divided into two groups (30 each) using a random number table: the conventional general anesthesia group (T group) and the non-intubated general anesthesia group (NT group). Patients in group T were induced with conventional general anesthetic, single-lung ventilated after intubation with double-lumen bronchial catheters. Patients in group NT were induced with general anesthesia combined nerve block, and spontaneous breathings were retained. The results of blood gas analysis, anesthesia time, operation time, intraoperative blood loss, time for orientation recovery and modified Aldrete score ≥ 9 minutes were recorded. The intraoperative and postoperative complications, postoperative hospital stay time, VAS and PC A scores 48 h after operation were recorded. Calculate the cost of anesthesia and the total cost of hospitalization. Results Compared with T group, NT group had lower pH value and higher PCO2 at 30 min before and after the thoracic closure, oxygenation index in the NT group increased at 30 min after the thoracic closure (P < 0.05). Compared with T group, anesthesia time, time for orientation recovery and modified Aldrete score ≥ 9 minutes, incidence of postoperative sore throat, postoperative hospital stay time, VAS scores at 6, 12 h and PC A at 48 h after the operation, anesthesia costs, and total hospitalization costs in the NT group were all reduced (P < 0.05). Conclusions Fully considering the safety, compared with the traditional tracheal intubation general anesthesia, non-intubation general anesthesia can not only promote postoperative outcomes but also improve the cost-effectiveness in the patients undergoing thoracoscopic bulla resection.