Journal of cardiothoracic and vascular anesthesia · 2026
Regional Anesthesia Combined With Respiratory Physiotherapy Improves Postoperative PaO₂:FiO₂ Ratio and Pulmonary Atelectasis in Thoracolaparoscopic Esophagectomy:A Randomized Controlled Trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Lin Jing, Yang Jinghao, He Yihang, Chang Yongliang, Zuo Youbo
Аннотация
OBJECTIVES: This study aimed to evaluate whether regional anesthesia combined with respiratory physiotherapy could enhance postoperative oxygenation and decrease pulmonary atelectasis after thoracolaparoscopic esophagectomy.
DESIGN: Randomized controlled trial.
SETTING: The operating room of a tertiary hospital.
PARTICIPANTS: Eighty-one patients diagnosed with esophageal cancer who were scheduled for elective thoracolaparoscopic esophagectomy.
INTERVENTIONS: Patients were randomly allocated into 3 groups: the control group (C group) received patient-controlled intravenous analgesia (PCIA) only; the regional anesthesia group (N group) received ultrasound-guided serratus anterior plane block combined with bilateral rectus abdominis sheath block and transversus abdominis plane block, plus PCIA; and the regional anesthesia combined with respiratory physiotherapy group (ND group) received the same regional blocks as the N group, followed by a structured respiratory physiotherapy protocol (including lateral rotation, manual hyperinflation, chest percussion, and suctioning) before extubation in the postanesthesia care unit, plus PCIA.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the PaO₂:FiO₂ ratio. Secondary outcomes included lung ultrasound scores, incidence of postoperative pulmonary complications, and recovery parameters. At 24 hours postoperatively, the PaO₂:FiO₂ ratio was significantly higher in the ND group than in both the C and N groups (p < 0.05). Overall lung ultrasound scores were significantly lower in the ND group than in the C and N groups at both 1 and 24 hours postoperatively (p < 0.05). The incidence of pulmonary atelectasis was significantly lower in the ND group (37.0%) than in the N (88.8%) and C (100.0%) groups (p < 0.01). The ND group also had the lowest rates of respiratory failure and unplanned reintubation compared with the other 2 groups (p < 0.05). Further, the ND group had the shortest hospital stay among the 3 groups (p < 0.05).
CONCLUSIONS: Regional anesthesia combined with respiratory physiotherapy significantly improved the PaO₂:FiO₂ ratio, reduced pulmonary atelectasis, and accelerated postoperative recovery after thoracolaparoscopic esophagectomy.
DESIGN: Randomized controlled trial.
SETTING: The operating room of a tertiary hospital.
PARTICIPANTS: Eighty-one patients diagnosed with esophageal cancer who were scheduled for elective thoracolaparoscopic esophagectomy.
INTERVENTIONS: Patients were randomly allocated into 3 groups: the control group (C group) received patient-controlled intravenous analgesia (PCIA) only; the regional anesthesia group (N group) received ultrasound-guided serratus anterior plane block combined with bilateral rectus abdominis sheath block and transversus abdominis plane block, plus PCIA; and the regional anesthesia combined with respiratory physiotherapy group (ND group) received the same regional blocks as the N group, followed by a structured respiratory physiotherapy protocol (including lateral rotation, manual hyperinflation, chest percussion, and suctioning) before extubation in the postanesthesia care unit, plus PCIA.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the PaO₂:FiO₂ ratio. Secondary outcomes included lung ultrasound scores, incidence of postoperative pulmonary complications, and recovery parameters. At 24 hours postoperatively, the PaO₂:FiO₂ ratio was significantly higher in the ND group than in both the C and N groups (p < 0.05). Overall lung ultrasound scores were significantly lower in the ND group than in the C and N groups at both 1 and 24 hours postoperatively (p < 0.05). The incidence of pulmonary atelectasis was significantly lower in the ND group (37.0%) than in the N (88.8%) and C (100.0%) groups (p < 0.01). The ND group also had the lowest rates of respiratory failure and unplanned reintubation compared with the other 2 groups (p < 0.05). Further, the ND group had the shortest hospital stay among the 3 groups (p < 0.05).
CONCLUSIONS: Regional anesthesia combined with respiratory physiotherapy significantly improved the PaO₂:FiO₂ ratio, reduced pulmonary atelectasis, and accelerated postoperative recovery after thoracolaparoscopic esophagectomy.