Trial reportBMC surgery2025
Tubeless anesthesia improves postoperative recovery following VATS wedge resection: a prospective randomized controlled study.
Trial report in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
Funding
Abstract
purposeThis study aimed to evaluate the effects of different tubeless anesthesia strategies on postoperative recovery in patients undergoing video-assisted thoracoscopic (VATS) wedge resection within an enhanced recovery after surgery (ERAS) protocol.
methodsIn this prospective randomized controlled trial, 120 patients scheduled for elective VATS wedge resection were randomly assigned to one of three groups: double-lumen endotracheal tube intubation (DLETT), laryngeal mask airway combined with intercostal nerve block (LMA + INB), or laryngeal mask airway combined with paravertebral block (LMA + PVB). Primary outcomes included length of hospital stay, time to ambulation and oral intake, and visual analog scale (VAS) pain scores. Secondary outcomes included intraoperative hemodynamics, arterial blood gas analysis, serum inflammatory cytokines (IL-6, IL-1β, TNF-α), postoperative complications, and total hospitalization costs.
resultsPatients in the LMA + PVB group had significantly shorter hospital stays and earlier ambulation compared to the DLETT group (p < 0.001). VAS pain scores at rest and during coughing were consistently lower in the LMA + PVB group from 6 to 24 h postoperatively (p < 0.01). Heart rate, mean arterial pressure, and oxygenation parameters—including peripheral capillary oxygen saturation (SpO₂), partial pressure of arterial oxygen (PaO₂), and arterial oxygen saturation (SaO₂)—remained within physiological ranges in all groups throughout the perioperative period. IL-6 and IL-1β levels at 24 h were significantly lower in the LMA groups (p < 0.01). While DLETT provided better surgical field visibility, it was associated with higher rates of sore throat and hoarseness, as well as greater hospitalization costs.
conclusionTubeless anesthesia, particularly LMA + PVB, enhances postoperative recovery following VATS wedge resection by reducing pain, inflammation, and hospitalization duration. These findings suggest that LMA + PVB may be a feasible alternative to conventional intubation-based anesthesia in selected clinical settings. CLINICAL
trial registrationThis study was registered at the Chinese Clinical Trial Registry (ChiCTR2300073484) on July 12, 2023.
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