A comparative study of two- versus one-lung ventilation for needlescopic bleb resection

Area of Science:

• Thoracic Surgery
• Anesthesiology
• Minimally Invasive Procedures

Background:

• Spontaneous pneumothorax management often involves surgical intervention.
• Needlescopic thoracic surgery offers a minimally invasive approach.
• Optimizing anesthesia techniques is crucial for patient outcomes and procedure efficiency.

Purpose of the Study:

• To evaluate the feasibility of two-lung (TL) ventilation with low tidal volume anesthesia.
• To compare TL ventilation with traditional one-lung (OL) ventilation for needlescopic bleb resection.
• To assess the impact on airway pressure, procedure time, and overall anesthesia duration.

Main Methods:

• Prospective study comparing TL and OL ventilation in 108 patients undergoing needlescopic bleb resection.
• TL group: tidal volume 4.0 mL·kg⁻¹, respiration rate 23 breaths·min⁻¹.
• OL group: tidal volume 8.0 mL·kg⁻¹, respiration rate 12 breaths·min⁻¹.

Main Results:

• Significantly lower airway pressure in the TL group (8.0 ± 3.3 mmHg) vs. OL group (24.0 ± 3.9 mmHg).
• Reduced time from intubation to incision in the TL group (17.1 ± 4.0 min) vs. OL group (35.3 ± 7.6 min).
• Shorter total anesthesia time in the TL group (64.9 ± 14.7 min) vs. OL group (77.9 ± 21.6 min).

Conclusions:

• Two-lung ventilation with low tidal volume is technically feasible for needlescopic bleb resection.
• This technique offers advantages in reduced airway pressure and shorter anesthesia time.
• Needlescopic bleb resection using TL ventilation is a cost-effective and time-saving alternative to OL ventilation.