Clinical application of preserving spontaneous breathing non‐intubation anesthesia in thoracoscopic surgery for lung cancer under ERAS concept

Qi, Longzhou; Chen, Ke; Luo, Bin; Mao, Guocai; Pan, Longfa; Huang, Haitao; Li, Jian; Chen, Shaomu

doi:10.1111/ajco.13726

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…It offers advantages over intubated anesthesia, including reduced healthcare costs. [4] Table 1 Case report timeline.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report

Xie,

Meng,

Pei

2024

Medicine

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Introduction: General laryngeal mask anesthesia with the preservation of spontaneous breathing has accelerated the advancement of the enhanced recovery after surgery concept in thoracoscopic surgery. However, the need for increased doses of anesthetic drugs to reduce laryngeal mask airway (LMA) stimulation poses challenges due to the increased risk of hypotension, respiratory depression, susceptibility to hypoxemia, and carbon dioxide retention, particularly in the lateral position. Patient concerns: During the perioperative period, reducing the dose of anesthetic drugs while simultaneously improving LMA tolerance and preventing circulatory and respiratory depression poses a challenge. Diagnoses: The patient was diagnosed with a nodule in the upper lobe of the left lung. Interventions: In this case, we chose remimazolam sedation, which mildly inhibits circulatory respiration, and used mucosal surface anesthesia in the pharynx. This approach improved the patient’s tolerance to LMA, reduced the dose of anesthetic drugs, and facilitated the successful thoracoscopic wedge resection of the upper lobe of the left lung with preservation of spontaneous respiration. Outcomes: During 2 weeks follow-up, the patient recovered satisfactorily and did not report any discomfort. Conclusion: We used pharyngeal mucosal surface anesthesia and thoracic paravertebral nerve block in combination with remimazolam sedation to provide precise analgesia, moderate sedation, and successful LMA general anesthesia with preservation of spontaneous respiration in patients undergoing thoracoscopic pulmonary wedge resection.

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“…It offers advantages over intubated anesthesia, including reduced healthcare costs. [4] Table 1 Case report timeline.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report

Xie,

Meng,

Pei

2024

Medicine

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“…Regular physical activity can not only reduce the incidence of certain types of cancer, such as lung cancer but also improve the survival rates and quality of life of cancer patients. [ 6 , 7 ] Nutrition management is also a crucial component of cancer treatment, and appropriate nutritional support can help patients maintain the necessary energy intake. Studies have shown that an intervention model combining nutrition and physical exercise is most effective in the pre-cachexia stage and can also enhance immunity, thereby supporting the rehabilitation process of cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an ERAS-based exercise-nutrition management model in enhancing postoperative recovery for thoracoscopic radical resection of lung cancer: A randomized controlled trial

Huang,

Hu,

Chen

2024

Medicine

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Background: To analyze the effect of an exercise-nutrition management model based on the Enhanced Recovery After Surgery (ERAS) concept on patients undergoing thoracoscopic radical surgery for lung cancer. Methods: From June 2019 to December 2022, 85 lung cancer patients who underwent thoracoscopic radical lung cancer surgery were randomly divided into 2 groups. The control group, consisting of 42 patients, received routine nursing care during the perioperative period. The study group, comprising 43 patients, implemented an exercise-nutrition management model based on the ERAS concept during the perioperative period. We compared general data, perioperative indicators, compliance, and complications between the 2 groups. Additionally, we assessed the nutritional status using the patient-generated subjective global assessment (PG-SGA), albumin (ALB), prealbumin (PA), and hemoglobin (Hb), as well as lung function, including forced expiratory volume in the first second (FEV1) and maximum voluntary ventilation (MVV), in the patient population following the Piper intervention. Results: In the study group, the times to first defecation and getting out of bed, the duration of thoracic drainage tube indwelling, and the length of hospital stay were shorter than those in the control group. The VAS scores on the 2nd and 3rd postoperative days were lower in the study group than in the control group (P < .05). Medication compliance was higher in the study group compared to the control group (P < .05). Post-intervention, the PG-SGA scores in the study group were lower, while PA, ALB, and Hb levels were higher than those in the control group (P < .05). The MVV, FEV1, and FVC values were higher in the study group than in the control group after the intervention (P < .05). The PFS and mMRC scores were lower in the study group compared to the control group after the intervention, and the QLQ-C30 scores were higher (P < .05). The incidence of complications was 6.98% in the study group, which was not significantly different from 11.90% in the control group (P > .05). Conclusion: The exercise-nutrition management model, based on the ERAS concept, exhibits significant perioperative effects in patients undergoing thoracoscopic radical resection of lung cancer, improving their nutritional status and reducing complications.

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“…Some recommendations have been developed for the ERAS guidelines in recent years to ensure that patients receive the best possible care 18 . There have been widely applied in a variety of surgical procedures, including gynecological oncologic surgery 19 , thoracic tumor surgery 20 , and urologic cancer surgery 21 – 23 . PCNL can also be surgically treated using ERAS.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of enhanced recovery after surgery among patients undergoing percutaneous nephrolithotomy: a systematic review and meta-analysis

Liu,

Xiao,

Yue

et al. 2024

International Journal of Surgery

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Background: The enhanced recovery after surgery (ERAS) method has been widely used in surgery and anesthesia worldwide and has been applied to a wide range of surgical specialties, including colorectal surgery, gynecology, liver surgery, breast surgery, urology, and spinal surgery. An increasing number of studies have demonstrated its safety and efficacy in various fields. The safety and effectiveness of ERAS for percutaneous nephrolithotomy (PCNL) remain controversial. This study aimed to review the safety and effectiveness of ERAS for PCNL. Methods: The Chinese National Knowledge Infrastructure (CNKI), Wan Fang, Chinese Biomedical Literature Service System (SinoMed), Chinese Science and Technology Journal Full Text Database (VIP), Cochrane Library, PubMed, Web of Science, and Embase databases were searched for eligible studies published until September 19, 2022. Outcome measures included postoperative hospital stay, total hospital stay, incidence of postoperative complications, stone-free rate (SFR), operative time, postoperative indwelling nephrostomy tube time, catheter encumbrance time, and nursing satisfaction. All analyses were performed using random effects or fixed effects models. Clinical heterogeneity was treated with subgroup, sensitivity, or descriptive analyses only when clinical heterogeneity was not excluded. Publication bias was assessed using funnel plots. Twenty-five studies (1,545 observational patients and 1,562 controls) were included. Results: The ERAS group had a shorter postoperative hospital stay [WMD=−2.59, 95% CI=(−3.04, −2.14), P<0.001], total hospital stay [WMD=−2.59, 95% CI=(−3.04, −2.14), P<0.001], and lower complication rate [RR=0.36, 95% CI=(0.29, 0.43), P<0.001] than the control group. The ERAS group had a shorter surgery time [WMD=−3.57, 95% CI=(−5.88, −1.26), P=0.003], postoperative indwelling nephrostomy tube time [WMD=−1.94, 95% CI=(−2.69, −1.19), P<0.001], catheter encumbrance time [WMD=−2.65, 95% CI=(−4.83, −0.46), P=0.02], and higher satisfaction [RR=1.15, 95% CI=(1.05, 1.25), P=0.001] than the control group. The difference in the stone-free rate between the two groups was not statistically significant [RR=1.03, 95% CI=(0.97, 1.09), P=0.38], but the stone-free rate of the observation group (ERAS group) in each study was higher than that of the control group. Conclusion: ERAS not only ensures the safety of PCNL but also promotes postoperative rehabilitation of patients (shorter surgery time, postoperative indwelling nephrostomy tube time, postoperative hospital time, and lower complication rate). At the same time, differences in the stone-free rate were not statistically significant, but the stone-free rate of ERAS in each study was higher than that of the usual care for PCNL patients.

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Clinical application of preserving spontaneous breathing non‐intubation anesthesia in thoracoscopic surgery for lung cancer under ERAS concept

Cited by 6 publications

References 14 publications

Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report

Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report

Effectiveness of an ERAS-based exercise-nutrition management model in enhancing postoperative recovery for thoracoscopic radical resection of lung cancer: A randomized controlled trial

Safety and efficacy of enhanced recovery after surgery among patients undergoing percutaneous nephrolithotomy: a systematic review and meta-analysis

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