Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study
Background: Pulmonary lobectomy is the standard of care for the treatment of early- stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national da...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2022-06-01
|
| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1811257521731534848 |
|---|---|
| author | Yahya Alwatari Vignesh Vudatha Daniel Scheese Salem Rustom Dawit Ayalew Athanasios E. Sevdalis Walker Julliard Rachit D. Shah |
| author_facet | Yahya Alwatari Vignesh Vudatha Daniel Scheese Salem Rustom Dawit Ayalew Athanasios E. Sevdalis Walker Julliard Rachit D. Shah |
| author_sort | Yahya Alwatari |
| collection | DOAJ |
| description | Background: Pulmonary lobectomy is the standard of care for the treatment of early-
stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental
anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or
open lobectomy using a national database and assessed the effect of regional block (RB)
on postoperative outcomes.
Methods: Patients who underwent lobectomy for lung cancer between 2014–2019 were
identified in the American College of Surgeons National Surgical Quality Improvement
Program. The patients’ primary mode of anesthesia and supplemental anesthesia were
recorded. Preoperative characteristics and postoperative outcomes were compared between
2 surgical groups: those who underwent general anesthesia (GA) alone versus GA
with RB. Multivariable regression analyses were performed on the outcomes of interest.
Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and
the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over
the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative
comorbidities were comparable between groups. Patients who underwent VATS were
more likely to receive RB than those who underwent thoracotomy. RB was most often
utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with
shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher
rate of surgical site infections (SSIs).
Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia
in patients undergoing lobectomy for lung cancer. RB utilization was associated
with a shorter length of hospital stay and an increase in SSI incidence. |
| first_indexed | 2024-04-12T17:58:44Z |
| format | Article |
| id | doaj.art-b11592c5656444348ad90d39396118dc |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-04-12T17:58:44Z |
| publishDate | 2022-06-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-b11592c5656444348ad90d39396118dc2022-12-22T03:22:15ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142022-06-0155322523210.5090/jcs.21.152Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective StudyYahya Alwatari0https://orcid.org/0000-0002-0219-3251Vignesh Vudatha1https://orcid.org/0000-0002-3624-3771Daniel Scheese2https://orcid.org/0000-0002-9367-1422Salem Rustom3https://orcid.org/0000-0001-6382-9113Dawit Ayalew4https://orcid.org/0000-0001-5638-7759Athanasios E. Sevdalis5https://orcid.org/0000-0001-7973-0150Walker Julliard6https://orcid.org/0000-0001-8951-1728Rachit D. Shah7https://orcid.org/0000-0002-3632-3034Virginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemVirginia Commonwealth University Health SystemBackground: Pulmonary lobectomy is the standard of care for the treatment of early- stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national database and assessed the effect of regional block (RB) on postoperative outcomes. Methods: Patients who underwent lobectomy for lung cancer between 2014–2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program. The patients’ primary mode of anesthesia and supplemental anesthesia were recorded. Preoperative characteristics and postoperative outcomes were compared between 2 surgical groups: those who underwent general anesthesia (GA) alone versus GA with RB. Multivariable regression analyses were performed on the outcomes of interest. Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative comorbidities were comparable between groups. Patients who underwent VATS were more likely to receive RB than those who underwent thoracotomy. RB was most often utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher rate of surgical site infections (SSIs). Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia in patients undergoing lobectomy for lung cancer. RB utilization was associated with a shorter length of hospital stay and an increase in SSI incidence.lobectomyanesthesianational surgical quality improvement programoutcomes |
| spellingShingle | Yahya Alwatari Vignesh Vudatha Daniel Scheese Salem Rustom Dawit Ayalew Athanasios E. Sevdalis Walker Julliard Rachit D. Shah Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study Journal of Chest Surgery lobectomy anesthesia national surgical quality improvement program outcomes |
| title | Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study |
| title_full | Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study |
| title_fullStr | Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study |
| title_full_unstemmed | Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study |
| title_short | Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study |
| title_sort | utilization of supplemental regional anesthesia in lobectomy for lung cancer in the united states a retrospective study |
| topic | lobectomy anesthesia national surgical quality improvement program outcomes |
| work_keys_str_mv | AT yahyaalwatari utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT vigneshvudatha utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT danielscheese utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT salemrustom utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT dawitayalew utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT athanasiosesevdalis utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT walkerjulliard utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy AT rachitdshah utilizationofsupplementalregionalanesthesiainlobectomyforlungcancerintheunitedstatesaretrospectivestudy |