Analysis of anesthesia management of thoracoscopic lobectomy for lung cancer
Li Yumei
Lu Min
Gu Shude
Chen Xueying
Abstract：Objective To study the application and the relative treatment of complication during thoracoscopic lobectomy treating lung cancer patients under fiberoptic bronchoscopy(FOB). Methods Seventy patients with lung cancer underwent thoracoscopic lobectomy from February 2009 to September 2013 were divided into study group(35 cases) and control group(35 cases) randomly. The American society of anesthesiologists (ASA) grade was Ⅰ-Ⅱ; cardiac functional grading (NYHA) wasⅠ-Ⅱ. Both groups were given double-lumen endotracheal intubation; study group were given bronchoscopy; control group were given lung auscultation. In the operation, single lung ventilation was used; invasive blood pressure(ABP), central intravenous pressure(CVP), heart rate(HR), 5-medical ECG, saturation of pulse oxygen(SpO2 ), PET CO2 and blood gas analysis were monitored. The blood gas and complications were compared. Results Intraoperative blood loss, postoperative drainage, urine output, operation time, single-lung ventilation time in study group were (95±27)ml, (130±66)ml, (566±81)ml, (132±47)min, (95±34)min; those in control group were (220±35) ml, (260±67) ml, (580±75)ml, (130±33)min, (113±27)min; intraoperative blood loss, postoperative drainage, and one-lung ventilation in study group were lower than those in control group, the difference was statistically significant P<0.05).There was only one case of hyoxmia in study group. Five cases of hyoxmia occurred in control group. During single lung ventilation, especially 15 minutes later, the statistics of SpO2, PaO2, PETCO2 was different. The SpO2, PaO2, PaCO2 in 15 minutes in study group were (77±7)mmHg,(122±28)mmHg,(35.2±2.4)mmHg and (98.1±0.7)%; the SpO2, PaO2, PETCO2 in 15 minutes in control group were (76±7)mmHg,(106±24)mmHg,(36.6±2.2)mmHg and (90.5±6.3)%. There was no statistics significance for average arterial pressure. There was no need of second time tracheal intubation for 70 studied cases. Three days after operation, seven cases of hyoxmia and nine cases hoarseness were found. Conclusions The DLT locating is accurate by using FOB and the isolation of double lungs is good. The hyoxmia is avoided during single lung ventilation.
Keywords：Lung neaplasmsFiberoptic bronchoscopyDouble-lumen-endotracheal-tubeSingle-lung- ventilationHypoxemia
Publication Date：2014-03-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 331-335 )