Thoracic Surgery Anesthesia Clinical Data Review And Meta-analysis

AN UNCONDITIONAL LOGISTIC REGRESSION ANALYSIS OF FACTORS OF PROLONGED PACU RETENTION TIME FOR THORACIC PATIENTSObjective: To explore the incidence and the possible risk factors which cause prolonged retention time at post-anesthetic care unit for patients undergoing thoracic surgeries and provide theoretical basis and references for future jobs dealing with such patients.Methods: In the archives room of anesthesia department, we searched out all the recording sheets of all the inpatients in thoracic department who underwent operations. We got in total 495 cases which were well recorded. Extract all useful data from anesthesia recording sheets and previous electronic medical records. For details see sheet 1. We typed in each piece of information extracted one by one and established an Excel form. Analysis of univariate and multivariate unconditional logistic regression was taken with the use of SPSS 13.0 software package.Outcome: when PACU retention time(Y) was greater than or equal 150 minutes, we make Y=1. When PACU retention time Y was less than 150 minutes, we make Y=0. Finally, 113 of the 495 cases with the ratio between male and female 2.36 were found to have Y=1. The total rate was 22.8%. Analysis of univariate and multivariate unconditional logistic regression showed the main risk factors were age(OR=0.000),operation method(OR=0.094),urine output (OR=0.000),ASA grading (OR=0.004) and administration of cardiovascular-activity agents(OR=0.002).Conclusion: staff working on post-anesthesia recovery of thoracic patients should pay attention to the main risk factors, find and solve related problems in time. The risk factors deserve future research. ONE-LUNG VENTILATION VERSUS TWO-LUNG VENTILATION IN ANESTHESIA FOR NON-CARDIAC THORACIC SURGERIES:A SYSTEMATIC REVIEWObjective: To evaluate the safety of One-lung ventilation and two-lungventilation in anesthesia for non-cardiac thoracic surgeriesMethods: A computerized search of articles published between 1980 and September 2008 was performed using The Cochrane Library,MEDLINE,EMBASE and Chinese Biomedicine Database(CBM) to identify the clinical trials comparing One-lung ventilation and two-lung ventilation in anesthesia for non-cardiac thoracic surgeries. The quality of included studies was critically assessed and data analyses were performed with Cochrane Collaboration's RevMan 5.0.Results: Five studies were included, involving 3 randomized trials,1 non- randomized trial and 1 retrospective trial. Meta-analyses showed that rates of blood-associated complications(including hypoxia and hypercapnia [OR=0.68,95%CI【0.31-1.51】P=0.46],tube intubation-associated complications(including tube malposition, poor isolation, hoarseness, bronchial erosion )[OR=153,95%CI【0.25-9.58】P=0.65],cardiovascular complications(including unstable hemodynamics, arrhythmia )[OR=1.00,95%C【I0.17-6.05】,P=1.00],respiration system complications(including pneumonia,pulmonary edema,atelectasis, ARDS)[OR=0.68,95%CI【0.31-1.51】P=0.35] were similar between one-lung ventilation and two-lung ventilation groups.Conclusions: Based on these evidences, One-lung ventilation for non-cardiac thoracic surgeries is as safe as two-lung ventilation, but hematological complications and surgical complications were not demonstrated. Due to the poor quality of the included trials, more high-quality randomized trials are needed.