Effect of Spontaneous Respiratory Thoracic Anesthesia and Double Lumen Tracheal Catheter Anesthesia on Persistent Cough after Pulmonary Resection in patients with Non-small Lung Cancer
LI Yang, QIAO Hui, YANG Guang
Department of Anesthesia,Beijing Shijitan Hospital,Beijing 100038
Abstract：【Objective】To investigate the effects of spontaneous respiratory thoracic anesthesia and double lumen tracheal (DLT) catheter anesthesia on persistent cough after pulmonary resection (CAP) in patients with non-small cell lung cancer (NSCLC) . 【Methods】A total of 482 patients with NSCLC who underwent surgery from February 2012 to May 2017 were enrolled. Patients were divided into the double-lumen tracheal catheter anesthesia group (T group, n=255) and spontaneous respiratory thoracic anesthesia group (S group, n=227) according to the anesthesia method. The S group was further divided into two sub-groups: intravenous intercostal nerve block anesthesia group (SB group, n=93) and intravenous epidural anesthesia group (SE group, n=134). The cough probabilities of the patient on the first day (T1), the second day (T2), the third day (T3), the first month (T4), and the third month (T5) after thoracoscopic surgery were recorded. Leicester cough questionnaire (LCQ) survey results, visual analogue score (VAS) and cough symptom scores were measured as well. Logistic regression was used to analyze the independent influencing factors of persistent cough after pulmonary resection (CAP) in patients. 【Results】After operation, the incidence of cough in the three groups decreased with time (P<0.05). The incidence of cough in the SE group and the SB group was significantly lower than that in the T group (P<0.05). There was no significant difference in the incidence of cough between the SE group and the SB group (P>0.05). After operation, the cough symptom score and VAS score in the T group were higher than those in the SE group and the SB group (P<0.05). The LCQ scores of patients in the T group were significantly lower than those in the SE group and the SB group; and the difference was statistically significant (P<0.05). However, there were no significant differences in cough symptoms scores, VAS scores, and LCQ scores between the SE group and the SB group (P>0.05). Multivariate analysis showed that age, smoking history, lymph nodes around the trachea, anesthesia time, and anesthesia mode were the risk factors for postoperative CAP. 【Conclusion】There is a certain correlation between anesthesia of lung surgery and postoperative CAP. Spontaneous respiratory anesthesia can significantly reduce the incidence of postoperative CAP, improve postoperative recovery and postoperative quality of life. Since age, smoking history, lymph nodes around the tracheal tree, anesthesia time and anesthesia mode are risk factors for postoperative CAP, special attentions should be paid.
李洋, 乔辉, 杨光. 自主呼吸胸腔麻醉与双腔气管导管麻醉对非小细胞肺癌手术患者术后持续咳嗽的影响[J]. 医学临床研究, 2020, 37(3): 393-396.
LI Yang, QIAO Hui, YANG Guang. Effect of Spontaneous Respiratory Thoracic Anesthesia and Double Lumen Tracheal Catheter Anesthesia on Persistent Cough after Pulmonary Resection in patients with Non-small Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2020, 37(3): 393-396.
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2020, Vol. 37 
