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Kazumichi Okabe



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    P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.06-18 - Comparison of Extubation Time of Pleulectomy/Decortication with Lobectomy Under General Anesthesia Using Desflurane (ID 11136)

      16:45 - 18:00  |  Author(s): Kazumichi Okabe

      • Abstract
      • Slides

      Background

      Pleurectomy/decortication (P/D) is an operation to dissect the entire visceral and parietal pleura. Chief complications are hemorrhage and prolonged air leak. To avoid mechanical ventilation postoperatively, good recovery of spontaneous respiration and emergence are importent. We evaluated emergence status in patients who were underwent P/D with desflurane (DES) anesthesia in the clinical settings.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Records of consecutive patients at our hospital who were underwent P/D from May 2013 to January 2018 and lung lobectomy via thoracotomy from June 2016 to August 2017 were collected. Patients anesthetized with DES were investigated. Lobectomy with chest wall resection were excluded. P/D group (n=19) and control group (n=20) were analyzed. General anesthesia was maintained with DES (3-5%), remifentanil, and rocronium combined with epidural anesthesia. Administration of DES was abruptly discontinued jist after postoperative X-ray examination. A patient was extubated after sugamadex was injected. Extubation time (T1) was defined as duration from the end of operation to extubation. Continuous variables were expressed as median and interququartile range (IQR). Fisher's exact test and Mann-Whitney U-tests were used for statistical analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      There were no significant difference in demographic data (age, gender, BMI, PaO2, Hb, ALB) between the two groups, except for %VC and FEV1%. All patients were extubated after surgery. There was no significant difference in T1 between the two groups. Despite significantly larger amount of blood loss, longer operation and anesthesia time in the P/D group, time independent recovery of DES was achieved as same as the control group.

      P/D group

      n=19

      Control group

      n=20

      P value
      %VC (%) 73 (64-89) 98 (84-107) <0.001
      FEV1% (%) 82 (76-85) 75 (64-81) <0.05
      Blood loss (mL/kg)

      29 (22-44)

      3 (1-7) <0.001
      Operation time (mim) 527 (458-555) 293 (257-326) <0.001
      Anesthesia time (min) 589 (531-626) 360 (313-397) <0.001
      T1 (min) 18 (16-25) 23 (16-29) 0.628

      8eea62084ca7e541d918e823422bd82e Conclusion

      This retrospective clinical study showes good emergence and recovery following prolonged desflurane anesthesia. Desflurane is a useful agent for patients underwent P/D.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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