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Abstract
Purpose: To determine the safety and clinical outcomes of epidural anaesthesia (EA) relative to internal intercostal nerve block (INB) in Chinese patients with non-small cell lung cancer (NSCLC) who were undergoing non-intubated thoracoscopic lobectomy.Methods: Chinese patients with NSCLC (stage I or II) with no evidence of metastasis were given either EA or INB, with equal number of patients in both groups. The peri-operative outcomes determined were duration of anaesthesia /duration of surgery, SpO2/PaCO2 levels, cases of hypotension, and blood loss. The post-operative outcome indices measured were pain score (determined using visual analogue scale (VAS), post-operative complications, chest drainage, duration of hospital stay, and deaths/mortality.Multiple regression analysis was used to confirm the results obtained in this study by adjusting potential covariates. Peri-operative and post-operative complications were compared between the two groups. The results obtained from 220 patients were subjected to statistical analysis.Results: Peri-operative results showed that patients who underwent INB had shorter duration of anaesthesia (12.3 vs 31.4 min, p < 0.05) and shorter duration of surgery (164.4 vs 197.2 min, p < 0.05) than patients who underwent EA for non-intubated lobectomy. Post-operative results showed that patients who underwent INB had significantly lower number of post-operative complications than those who received EA (29 vs 44 %, p < 0.05). The most common post-operative complications among patients in both treatment groups were nausea, vomiting, emphysema and pulmonary complications. Patients who underwent INB had shorter hospital stay than those who underwent EA (5.1 vs 7.5 days, p < 0.05). These results were confirmed through multiple regression analysis.Conclusion: These findings favour the use of INB for regional anaesthesia in NSCLC patients undergoing non-intubated lobectomy.
Highlights
Non-small cell lung cancer (NSCLC) is one of the common causes of mortality worldwide [1]
A total of 210 Chinese NSCLC patients who satisfied all the eligibility criteria were enrolled in this study
The findings of the present study have shown that intercostal nerve block (INB) and Epidural anaesthesia (EA) are effective and safe in NSCLC patients undergoing non-intubated lobectomy
Summary
Non-small cell lung cancer (NSCLC) is one of the common causes of mortality worldwide [1]. Surgical intervention is the only treatment option used in the management of lung cancer (LC). Lung lobectomy (LL) is one of the standard surgical interventions for the management of patients with early-stage It has been observed that after lobectomy, the chances of survival in patients with NSCLC are more than 80 %. It has been reported that non-intubated thoracoscopic lobectomy has more benefits than tracheal intubation procedure [5]. The potential benefits of using non-intubated thoracoscopic lobectomy include lower incidence of sore throat, rapid recovery, lower complications, and shorter hospital stay [5,6]. Epidural anaesthesia (EA), with or without conscious sedation, has been used in thoracic surgeries in the past decades [5,6,7]
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