4.5 Article

Which Anesthesia Regimen Is Best to Reduce Pulmonary Complications After Head and Neck Surgery?

期刊

LARYNGOSCOPE
卷 131, 期 1, 页码 E108-E115

出版社

WILEY
DOI: 10.1002/lary.28724

关键词

Intravenous anesthesia; inhalational anesthesia; postoperative pulmonary complications; head and neck surgery

资金

  1. National Natural Science Foundation of China [81372043]
  2. Beijing Natural Science Foundation, China [7162199]

向作者/读者索取更多资源

The study aimed to compare the effects of propofol and sevoflurane on the incidence of postoperative pulmonary complications in head and neck cancer surgery. The results showed a significantly lower incidence of PPCs in the sevoflurane group compared to the propofol group, especially in patients who underwent tracheotomy postoperatively.
Objectives/Hypothesis The differences between intravenous and inhalation anesthesia in clinical postoperative pulmonary complications (PPCs) have been studied in cardiac and lung resection surgery. Clinical evidence for the effects of these two anesthetics on PPCs in other types of surgery is still missing. We aimed to assess the impact of sevoflurane and propofol on the incidence of PPCs in patients undergoing surgery for head and neck cancer. Study Design Double-blind, randomized, controlled trial. Methods We assigned 220 adults at intermediate-to-high risk of PPCs scheduled for head and neck cancer surgery with radial forearm or fibular flap reconstruction to either propofol or sevoflurane as a general anesthetic. The occurrence of pulmonary complications according to the Clavien-Dindo score was defined as the primary (within 7 days after surgery) outcome. Results The PPC incidence during 7 days after surgery was 32.4% and 18.2% in the propofol and sevoflurane groups, respectively (P = .027). The corresponding incidence of PPCs in patients who underwent tracheotomy at the end of surgery in the two groups was 44.8% and 24.5%, respectively (P = .030). In addition, the Clavien-Dindo classification showed significant differences between groups in minor complications (grades I and II) but not in major complications (grades III-V). Conclusions Compared with intravenous anesthesia, the administration of sevoflurane reduces the incidence of minor PPCs (grades I and II) in moderate- and high-risk patients who have undergone tracheotomy after head and neck cancer surgery with radial forearm or fibular flap reconstruction. Level of Evidence 2 Laryngoscope, 2020

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