Application and Comparison of Different Anesthetic Ventilation Methods in Minimally Invasive Thoracic Surgery Training

Abstract

Objective To compare the effectiveness and safety of one-lung ventilation and small tidal volume two-lung ventilation anesthesia methods in the training of minimally invasive thoracic surgery on experimental pigs. Methods Forty experimental pigs undergoing robotic thoracic surgery were randomly divided into two groups: two-lung ventilation group (n=20) and one-lung ventilation group (n=20). The two-lung ventilation group underwent single-lumen tracheal intubation, utilizing a small tidal volume with a fast respiratory rate combined with carbon dioxide pneumothorax for anesthesia ventilation during the operation. The one-lung ventilation group received one-lung ventilation using a double-lumen bronchial catheter placed under fiberoptic bronchoscopic guidance. The anesthesia implementation indexes from the two groups were compared, including the values of vital signs such as operative heart rate (HR), noninvasive mean blood pressure (MAP), end-tidal carbon dioxide (ETCO2), and oxygen saturation (SpO2), as well as the assessment of surgical training performance. Results The intubation success rate for animals in both groups was 100%, with no intraoperative deaths. The intubation completion time was significantly shorter in the two-lung ventilation group compared to the one-lung ventilation group (P < 0.001). Within each group, SpO2 levels were significantly higher in the two-lung ventilation group at 30 minutes after the start of thoracic surgery (T1) and at surgery completion (T3) compared to 60 minutes after the start of surgery (T2) (P<0.05). ETCO2, HR, and MAP were significantly higher at T2 and T3 compared to T1 (P<0.05). In the one-lung ventilation group, SpO2 levels were significantly higher at T1 and T3 compared to T2 (P<0.05), while ETCO2 levels gradually increasing over time (P<0.05). In the between-group comparisons at the same time points, SpO2 levels of the two-lung ventilation group were significantly higher than those of the one-lung ventilation group at all time points (T1, T2, T3) (P<0.05). Conclusion Both one-lung ventilation and two-lung ventilation anesthesia methods are effective and safe for use in surgical training, with controllable effects on intraoperative animal vital signs and minimal impact on surgical operation training, meeting the needs of robotic thoracic surgery training. One-lung ventilation provides a better experience during pneumonectomy procedures, while small tidal volume two-lung ventilation is easier to implement and does not require additional equipment purchase, making it a feasible supplemental anesthesia option for thoracoscopic surgery on experimental pigs.

Keywords

• experimental pig
• anesthesia
• thoracoscopy surgery
• airway management
• surgical robot training