Clinical Study Of Cough Symptoms After Non-intubated Anesthesia For Thoracoscopic Pneumonectomy

Objective: Cough is the most common symptom after thoracic surgery pneumonectomy,which seriously affects patients’ quality of life after surgery.Intubated video-assisted thoracic surgery(I-VATS)is the standard of care for pneumonectomy,but I-VATS tends to damage the airway mucosa,causing postoperative cough and other respiratory symptoms.Non-intubated video-assisted thoracic surgery(NI-VATS)uses a laryngeal mask or mask instead of a tracheal tube to avoid contact with the airway,thereby reducing postoperative symptoms such as cough.The aim of this study was to investigate the effect of NI-VATS on cough symptoms in the short term after pneumonectomy.Methods: A total of 302 patients who underwent VATS pneumonectomy in the Thoracic Surgery Department of First People’s Hospital of Yunnan Province from February 2022 to February 2023 were analyzed.According to the surgical modality,they were divided into wedge cut group,segment cut group and lobectomy group,and all patients received two types of anesthesia,non-tracheal intubation or tracheal intubation,respectively.Cough Symptom Scoring(CSS)combined with Visual analogue scale(VAS)was used to count all patients’ cough in the first three days after surgery.CSS and VAS scale scores were counted once a day and once a night and mean values were calculated,then general clinical information,perioperative related indicators,and examination results of all patients were recorded.Comparative analysis of the effects of two types of anesthesia on cough symptoms and recovery indicators in patients after pneumonectomyResults: This study included 67 in the NI-VATS wedge cut group,63 in the I-VATS wedge cut group,42 in the NI-VATS segment cut group,41 in the I-VATS segment cut group,52 in the NI-VATS lobectomy group,and 37 in the I-VATS lobectomy group,respectively.The general clinical data of the patients in each group were not statistically significant(p >0.05)comparablely.The intraoperative blood loss,postoperative drainage volume and postoperative drainage days in the NI-VATS wedge cut group were significantly less than those in the I-VATS wedge cut group(p <0.05).Patients in the NI-VATS segment cut group had significantly better postoperative drainage,postoperative drainage days,and hospital costs than those in the I-VATS segment cut group(p < 0.05).Patients in the NI-VATS lobotomy group had better postoperative leukocyte changes,postoperative drainage,postoperative drainage days,postoperative length of stay and hospital costs than those in the I-VATS lobotomy group(p <0.05).The frequency,extent,and impact of cough on life in the first three postoperative days were significantly lower in the NI-VATS group than in the I-VATS group in all three groups(p < 0.001).Conclusion: NI-VATS can improve cough in thoracic surgery patients in the short term after pneumonectomy,reduce postoperative drainage and drainage days,accelerate rapid postoperative recovery and improve patients’ postoperative quality of life.