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Abstract：
Understanding the intricate relationship between cancer clinicopathological features and anesthetics dosage is crucial for optimizing patient outcomes and safety during surgery. This retrospective study investigates this relationship in patients with non-small cell lung cancer (NSCLC) undergoing video-assisted thoracic surgery (VATS). A comprehensive analysis of medical records was undertaken for NSCLC patients who underwent VATS with intravenous compound inhalation general anesthesia. Patients were categorized based on histological, chemotherapy, radiotherapy, and epidural anesthesia factors. Statistical analysis was performed to compare the differences between the groups. The results revealed compelling insights. Specifically, patients with lung adenocarcinoma (LUAD) undergoing VATS exhibited higher dosages of rocuronium bromide and midazolam during general anesthesia, coupled with a shorter post-anesthesia care unit (PACU) stay compared to those with squamous cell carcinoma (sqCL). Furthermore, chemotherapy patients undergoing VATS demonstrated diminished requirements for phenylephrine and remifentanil in contrast to their non-chemotherapy counterparts. Similarly, radiotherapy patients undergoing VATS demonstrated a decreased necessity for rocuronium bromide compared to non-radiotherapy patients. Notably, patients who received epidural anesthesia in combination with general anesthesia manifested reduced hydromorphone requirements and prolonged hospital stays compared to those subjected to general anesthesia alone. In conclusion, the findings from this study indicate several important observations in diverse patient groups undergoing VATS. The higher dosages of rocuronium bromide and midazolam in LUAD patients point to potential differences in drug requirements among varying lung cancer types. Additionally, the observed shorter PACU stay in LUAD patients suggests a potentially expedited recovery process. The reduced anesthetic requirements of phenylephrine and remifentanilin chemotherapy patients indicate distinct responses to anesthesia and pain management. Radiotherapy patients requiring lower doses of rocuronium bromide imply a potential impact of prior radiotherapy on muscle relaxation. Finally, the combination of epidural anesthesia with general anesthesia resulted in reduced hydromorphone requirements and longer hospital stays, suggesting the potential benefits of this combined approach in terms of pain management and postoperative recovery. These findings highlight the importance of tailoring anesthesia strategies for specific patient populations to optimize outcomes in VATS procedures.
摘要：
了解癌症临床病理特征与麻醉药剂量之间的复杂关系对于优化患者预后和手术安全性至关重要。这项回顾性研究调查了接受电视胸腔镜手术（VATS）的非小细胞肺癌（NSCLC）患者的这种关系。对接受VATS和静脉复合吸入全身麻醉的NSCLC患者的病历进行了全面分析。根据组织学对患者进行分类，化疗,放射治疗,和硬膜外麻醉因素。进行统计学分析以比较组间的差异。结果揭示了令人信服的见解。具体来说,肺腺癌（LUAD）患者在全身麻醉期间出现较高剂量的罗库溴铵和咪达唑仑，与鳞状细胞癌（sqCL）患者相比，麻醉后监护病房（PACU）的停留时间更短。此外，与非化疗患者相比,接受VATS的化疗患者对苯肾上腺素和瑞芬太尼的需求降低.同样，与非放疗患者相比,接受VATS的放疗患者对罗库溴铵的必要性降低.值得注意的是,与仅接受全身麻醉的患者相比,接受硬膜外麻醉联合全身麻醉的患者减少了氢吗啡酮的需求,并延长了住院时间.总之,这项研究的结果表明,在接受VATS的不同患者组中有几项重要观察结果.在LUAD患者中，罗库溴铵和咪达唑仑的剂量较高，这表明在不同类型的肺癌中药物需求存在潜在差异。此外,观察到的LUAD患者PACU住院时间较短,提示患者可能会加快康复过程.去氧肾上腺素和瑞芬太尼化疗患者的麻醉需求降低表明对麻醉和疼痛管理的反应不同。需要较低剂量罗库溴铵的放射治疗患者暗示先前放射治疗对肌肉松弛的潜在影响。最后,硬膜外麻醉与全身麻醉的组合导致氢吗啡酮的需求减少和住院时间延长。提示这种联合方法在疼痛管理和术后恢复方面的潜在益处.这些发现强调了为特定患者人群定制麻醉策略以优化VATS程序结果的重要性。
