非气管插管保留自主呼吸麻醉技术在胸腔镜手术中应用进展

摘要

胸腔镜手术需要相对静止、充分清晰的术野,施行泄露测试时需要调整气道压力,因此通常在全身麻醉插入双腔管实施单肺通气下进行手术.与气管插管全麻相比,非气管插管保留自主呼吸麻醉下胸腔镜手术在技术上更具挑战性,但是具有术后呼吸系统并发症发生率低、创伤小、术后苏醒迅速、手术室停留时间和住院时间短等优势.因此,近年随着麻醉和外科手术技术的提高及镇静药物和麻醉手术耗材的优化发展,非气管插管麻醉逐渐应用于胸腔镜手术.本文将对非气管插管胸腔镜手术的发展简史、麻醉选择、围术期相关麻醉问题进行综述.%Thoracoscopic surgery requires a relatively static,fully clear surgical field and the leakage test of air needs to adjust the airway pressure,so thoracoscopic surgery is usually performed under general anesthesia with double lumen tracheal intubation in a single lung ventilation.Compared with general anesthesia with double lumen tracheal intubation,non-tracheal intubation anesthesia with spontaneous breathing is more challenging in thoracoscopic surgery,in addition to advantages of a low incidence of postoperative respiratory complications,minor trauma,rapid postoperative recovery,short in operation room stay,hospital stay,etc.Therefore,with improvement of anesthesia and surgical techniques and optimal development of sedation drugs and consumable items of anesthesia in recent years,anesthesia with non-tracheal intubation is gradually applied in thoracoscopic surgery.In this paper,we reviewed the brief history,anesthesia selection,perioperative anesthesiarelated issues of thoracoscopic surgery with non-tracheal intubation.