Total intravenous anesthesia shortens hospital stay after lung resection surgery: A propensity score matching study.

Abstract

Background There is no consensus regarding the superiority of volatile or total intravenous anesthesia (TIVA) in reducing the incidence of postoperative pulmonary complications (PPCs) after lung resection surgery (LRS). Thus, the aim of this study was to investigate the effects of TIVA and volatile anesthesia on the incidence of PPCs in patients who underwent LRS. We hypothesized that TIVA is associated with a lower incidence of PPCs than volatile anesthesia.Methods This was a retrospective cohort study of patients who underwent LRS at Taipei Veterans General Hospital between January 2016 and December 2020. The patients’ charts were reviewed and data on patient characteristics, perioperative features, and postoperative outcomes were extracted and analyzed. The patients were categorized into TIVA and volatile anesthesia groups and their clinical data were compared. Propensity score matching was performed to reduce potential selection bias. The primary outcome was the difference between the incidence of PPCs in the volatile anesthesia and TIVA groups, whereas the secondary outcomes were the differences in the incidences of other postoperative events, such as length of hospital stay (LOS) and postoperative nausea and vomiting (PONV), between the two groups.Results A total of 396 patients each were included in the TIVA and volatile anesthesia groups. There was no statistically significant difference in the incidence of PPCs between the volatile anesthetic and TIVA groups. The TIVA group had a shorter LOS (p < 0.001) and a lower incidence of PONV than the volatile anesthesia group (4.5% in the TIVA group vs. 8.8% in the volatile anesthesia group; p = 0.016). However, there were no significant differences in reintubation, 30-day readmission, and reoperation rates between the two groups.Conclusions There is no significant difference between the incidence of PPCs in patients who underwent LRS under TIVA and that in patients who underwent LRS under volatile anesthesia. However, TIVA may be a better choice for maintenance of anesthesia in patients undergoing LRS.