Nonintubated thoracic anesthesia and postoperative cough after video-assisted thoracoscopic surgery: A propensity...

This study aimed to evaluate the association of nonintubated thoracic anesthesia with postoperative in-hospital antitussive medication use and postoperative complications after video-assisted thoracoscopic surgery.

This single-center retrospective cohort study included 223 patients who underwent video-assisted thoracoscopic surgery between January and December 2025. The exposure was nonintubated thoracic anesthesia (NITS) versus double-lumen tube intubation. The primary outcome was postoperative in-hospital antitussive medication use. Secondary outcomes included chronic cough, sore throat, hoarseness, overall postoperative complications, postoperative pulmonary complications (PPCs), and antibiotic use beyond 48 h. Propensity score-based stabilized inverse probability of treatment weighting was applied.

After weighting, NITS was associated with lower odds of postoperative antitussive medication use (odds ratio [OR]: 0.46; 95% confidence interval [CI]: 0.25-0.85; P = 0.013), chronic cough (OR: 0.36; 95% CI: 0.16-0.84; P = 0.019), and hoarseness (OR: 0.27; 95% CI: 0.08-0.87; P = 0.029). NITS was also associated with lower odds of overall postoperative complications (OR: 0.50; 95% CI: 0.27-0.94; P = 0.031). No significant association was observed for PPCs (OR: 1.03; 95% CI: 0.49-2.19; P = 0.929).

In this propensity score-weighted retrospective cohort study, NITS was associated with lower odds of postoperative in-hospital antitussive medication use, chronic cough, hoarseness, and overall postoperative complications after video-assisted thoracoscopic surgery but not with PPCs. Prospective randomized studies are needed to confirm these findings.