Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (12): 29-37.doi: 10.6040/j.issn.1671-7554.0.2020.0454

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Effect of non-intubated spontaneous ventilation anesthesia used in video-assisted thoracoscopic surgery: a Meta-analysis

MA Weijiang,WANG Gaojun,OUYANG Xun,ZANG Chenxi,LIU Xin   

  1. Department of Thoracic Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
  • Published:2020-12-08

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Abstract: Objective To compare the efficacy of non-intubated spontaneous ventilation anesthesia and traditional general anesthesia with tracheal intubation used in video-assisted thoracoscopic surgery. Methods The databases like CNKI, Wangfang, VIP, CBM, PubMed, Embase and Cochrane Library were retrieved for original researches to compare the effect of non-intubated(experimental group)and intubated(control group)video-assisted thoracoscopic surgery. After evaluating the quality of the literatures, the satisfactory literatures were included and the research results were extracted. A Meta-analysis was performed on the operation time, intraoperative bleeding volume, lowest saturation of pulse oxygen(SpO2)during surgery, intraoperative maximum end-tidal carbon dioxide(ETCO2), postoperative duration of chest tube, postoperative hospital stays, postoperative total complication rate with RevMan5.3 software. Results A total of 27 studies and 2019 patients were enrolled into this study. The Meta-analysis results showed there was no statistical difference in operation time(SMD=-0.02,95%CI: -0.26-0.22,P=0.89)and lowest SpO2 during surgery(SMD=-0.10,95%CI: -0.53-0.33,P=0.66)between the experimental group and control group. The intraoperative bleeding volume(SMD=-0.13,95%CI: -0.24 - 0.01,P=0.03), postoperative duration of chest tube(SMD=-0.48, 95%CI: -0.68 - 0.28, P<0.001), postoperative hospital stays(SMD=-0.69, 95%CI: -1.05 - 0.33, P<0.001), postoperative total complication rate(OR=0.42, 95%CI: 0.25-0.70, P<0.001)in experimental group was significantly decreased than those in control group; however, the maximum ETCO2 in experimental group was higher than that in control group(SMD=1.23, 95%CI: 0.68-1.78, P<0.001). Conclusion Compared with traditional general anesthesia with tracheal intubation, non-intubated spontaneous ventilation anesthesia is safe and feasible with the advantages of shorter duration of chest tube, shorter postoperative hospital stay and fewer postoperative complication rate.

Key words: Non-intubated, Intubated, Spontaneous ventilation, General anesthesia, Video-assisted thoracoscopic surgery

CLC Number: 

  • R655
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