Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study
Abstract Background There is no consensus regarding the superiority of volatile or total intravenous anesthesia (TIVA) in reducing the incidence of postoperative pulmonary complications (PPCs) after lung resection surgery (LRS). Thus, the aim of this study was to investigate the different anesthetic...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02260-4 |
| _version_ | 1827708771115204608 |
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| author | Fu-Kai Hsu Hung-Wei Cheng Wei-Nung Teng Po-Kuei Hsu Han-Shui Hsu Wen-Kuei Chang Chien‑Kun Ting |
| author_facet | Fu-Kai Hsu Hung-Wei Cheng Wei-Nung Teng Po-Kuei Hsu Han-Shui Hsu Wen-Kuei Chang Chien‑Kun Ting |
| author_sort | Fu-Kai Hsu |
| collection | DOAJ |
| description | Abstract Background There is no consensus regarding the superiority of volatile or total intravenous anesthesia (TIVA) in reducing the incidence of postoperative pulmonary complications (PPCs) after lung resection surgery (LRS). Thus, the aim of this study was to investigate the different anesthetic regimens and the incidence of PPCs in patients who underwent LRS. We hypothesized that TIVA is associated with a lower incidence of PPCs than volatile anesthesia. Methods This was a retrospective cohort study of patients who underwent LRS at Taipei Veterans General Hospital between January 2016 and December 2020. The patients’ charts were reviewed and data on patient characteristics, perioperative features, and postoperative outcomes were extracted and analyzed. The patients were categorized into TIVA or volatile anesthesia groups and their clinical data were compared. Propensity score matching was performed to reduce potential selection bias. The primary outcome was the incidence of PPCs, whereas the secondary outcomes were the incidences of other postoperative events, such as length of hospital stay (LOS) and postoperative nausea and vomiting (PONV). Results A total of 392 patients each were included in the TIVA and volatile anesthesia groups. There was no statistically significant difference in the incidence of PPCs between the volatile anesthesia and TIVA groups. The TIVA group had a shorter LOS (p < 0.001) and a lower incidence of PONV than the volatile anesthesia group (4.6% in the TIVA group vs. 8.2% in the volatile anesthesia group; p = 0.041). However, there were no significant differences in reintubation, 30-day readmission, and re-operation rates between the two groups. Conclusions There was no significant difference between the incidence of PPCs in patients who underwent LRS under TIVA and that in patients who underwent LRS under volatile anesthesia. However, TIVA had shorter LOS and lower incidence of PONV which may be a better choice for maintenance of anesthesia in patients undergoing LRS. |
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| format | Article |
| id | doaj.art-cb3532a4b41c47a5b255732d1f060b2c |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-10T17:10:30Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-cb3532a4b41c47a5b255732d1f060b2c2023-11-20T10:41:59ZengBMCBMC Anesthesiology1471-22532023-10-012311810.1186/s12871-023-02260-4Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching studyFu-Kai Hsu0Hung-Wei Cheng1Wei-Nung Teng2Po-Kuei Hsu3Han-Shui Hsu4Wen-Kuei Chang5Chien‑Kun Ting6Department of Anesthesiology, Taipei Veterans General HospitalDepartment of Anesthesiology, Taipei Veterans General HospitalDepartment of Anesthesiology, Taipei Veterans General HospitalSchool of Medicine, National Yang Ming Chiao Tung UniversitySchool of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, Taipei Veterans General HospitalDepartment of Anesthesiology, Taipei Veterans General HospitalAbstract Background There is no consensus regarding the superiority of volatile or total intravenous anesthesia (TIVA) in reducing the incidence of postoperative pulmonary complications (PPCs) after lung resection surgery (LRS). Thus, the aim of this study was to investigate the different anesthetic regimens and the incidence of PPCs in patients who underwent LRS. We hypothesized that TIVA is associated with a lower incidence of PPCs than volatile anesthesia. Methods This was a retrospective cohort study of patients who underwent LRS at Taipei Veterans General Hospital between January 2016 and December 2020. The patients’ charts were reviewed and data on patient characteristics, perioperative features, and postoperative outcomes were extracted and analyzed. The patients were categorized into TIVA or volatile anesthesia groups and their clinical data were compared. Propensity score matching was performed to reduce potential selection bias. The primary outcome was the incidence of PPCs, whereas the secondary outcomes were the incidences of other postoperative events, such as length of hospital stay (LOS) and postoperative nausea and vomiting (PONV). Results A total of 392 patients each were included in the TIVA and volatile anesthesia groups. There was no statistically significant difference in the incidence of PPCs between the volatile anesthesia and TIVA groups. The TIVA group had a shorter LOS (p < 0.001) and a lower incidence of PONV than the volatile anesthesia group (4.6% in the TIVA group vs. 8.2% in the volatile anesthesia group; p = 0.041). However, there were no significant differences in reintubation, 30-day readmission, and re-operation rates between the two groups. Conclusions There was no significant difference between the incidence of PPCs in patients who underwent LRS under TIVA and that in patients who underwent LRS under volatile anesthesia. However, TIVA had shorter LOS and lower incidence of PONV which may be a better choice for maintenance of anesthesia in patients undergoing LRS.https://doi.org/10.1186/s12871-023-02260-4AnesthesiaPostoperative pulmonary complicationsLung resection surgeryVolatile anesthesiaTotal intravenous anesthesia |
| spellingShingle | Fu-Kai Hsu Hung-Wei Cheng Wei-Nung Teng Po-Kuei Hsu Han-Shui Hsu Wen-Kuei Chang Chien‑Kun Ting Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study BMC Anesthesiology Anesthesia Postoperative pulmonary complications Lung resection surgery Volatile anesthesia Total intravenous anesthesia |
| title | Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study |
| title_full | Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study |
| title_fullStr | Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study |
| title_full_unstemmed | Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study |
| title_short | Total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery: a propensity score matching study |
| title_sort | total intravenous anesthesia decreases hospital stay but not incidence of postoperative pulmonary complications after lung resection surgery a propensity score matching study |
| topic | Anesthesia Postoperative pulmonary complications Lung resection surgery Volatile anesthesia Total intravenous anesthesia |
| url | https://doi.org/10.1186/s12871-023-02260-4 |
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