Application of Asphyxiation Technique in Thoracoscopic Segmentectomy

Xuan CHAI; Zhonghui WANG; Yahong WANG; Guangshun LIU; Zhenchao LV; Shihao SHAO

doi:10.12259/j.issn.2095-610X.S20230502

Volume 44 Issue 5

May 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(5): 144-153

Xuan CHAI, Zhonghui WANG, Yahong WANG, Guangshun LIU, Zhenchao LV, Shihao SHAO. Application of Asphyxiation Technique in Thoracoscopic Segmentectomy[J]. Journal of Kunming Medical University, 2023, 44(5): 144-153. doi: 10.12259/j.issn.2095-610X.S20230502

Citation:

Xuan CHAI, Zhonghui WANG, Yahong WANG, Guangshun LIU, Zhenchao LV, Shihao SHAO. Application of Asphyxiation Technique in Thoracoscopic Segmentectomy[J]. Journal of Kunming Medical University, 2023, 44(5): 144-153. doi: 10.12259/j.issn.2095-610X.S20230502

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Application of Asphyxiation Technique in Thoracoscopic Segmentectomy

doi: 10.12259/j.issn.2095-610X.S20230502

Dept. of Anesthesiology，Yunnan Cancer Hospital/The 3rd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650118，China

Received Date: 2023-01-22
Publish Date: 2023-05-25

Abstract

Abstract

Objective To observe the effects of asphyxia oxygenation on intersegment plane display rate, intraoperative oxygen metabolism indexes, serum hypoxia inducible factor 1α （HIF-1α） and postoperative complications. Methods 75 patients aged 22 to 65 years with ASA grade I to II were randomly divided into 3 groups, with 25 cases in each group. Group C was given one-lung mechanical ventilation; In T1 group, oxygen was given at the ventilation side of double-lumen endotracheal tube for 3 L/min for asphyxia and oxygenation; In T2 group, oxygen was given for 7L/min through the ventilation side of double-lumen endotracheal tube for asphyxia oxygenation. SpO₂, HR, MAP, CO, CI, SV, pH, Hb, PO₂/FiO_2, PaCO₂, A-aO₂, Lac, O₂Hb, hHb, ScvO₂, CvO₂, were monitored and recorded before the anesthesia induction （T0）, 15 min after bilateral ventilation （t1）, 15 min after one-lung ventilation （T2）, after double-lung recruitment with pure oxygen （T3）, immediately after the interval plane display （T4） and 15 min after tracheal extubation and DO₂, VO₂ and O₂ER were calculated. The level of HIF-1α was detected by venous blood samples before the surgery, immediately after the surgery and 24 hours after the surgery. The occurrence time of ideal intersegment plane, single lung ventilation time, operation time, postoperative recovery time, extubation time, intraoperative infusion volume, urine volume, blood loss, postoperative hospitalization days, and postoperative complications were recorded. Results （1） The interval plane display time of T₁ and T₂ groups was shorter than that of C group, and the difference was statistically significant （P < 0.05）. （2） The serum hypoxia induction factor 1α level immediately after the surgery and 24 h after the surgery in 3 groups was higher than that before the surgery, the difference was statistically significant （ P < 0.05）. （3） At T ₄, VO₂, O₂ER, pH, PO₂/FiO₂, A-aO₂ and O₂Hb in groups T₁ and T₂ were lower than those in group C, with the statistical significance （P < 0.05）. ScvO ₂, PCO₂ and hHb were higher than those in group C, and the difference was statistically significant （P < 0.05）. Conclusion Asphyxiation technique can effectively accelerate the intersegmental plane display rate and ensure the adequate oxygen supply during the operation. It has no obvious influence on the balance of oxygen supply and demand of the body and the intracellular oxygen environment. It has good safety at the level of cells, tissues and organs, and can be applied in the clinical practice.
- Thoracoscopic segmentectomy,
- Asphyxiation technique,
- Intersegmental plane,
- Oxygen metabolism index,
- Serum hypoxia inducible factor 1α

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References(22)

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