24. Evaluation of feasibility and safety of non-intubated anesthesia video-assisted thoracoscopic thymectomy for myasthenia gravis

Tóm tắt

Video-assisted thoracoscopic surgery (VATS) thymectomy is a well-established treatment for Myasthenia gravis (MG). However, traditional VATS thymectomy uses general anesthesia with endotracheal intubation, which can worsen MG symptoms. This study evaluated the feasibility and safety of non-intubated anesthesia VATS for patients with MG to solve this issue. It was a prospective, descriptive study involving six patients aged 18 to 60, ASA I, II, who underwent VATS thymectomy under non-intubated anesthesia and local anesthesia at Vietduc University Hospital between May 2022 and December 2023. The induction time was short, ranging from 3 to 4.5 minutes. The median of Peak PaCO2 and EtCO2 were 42.5 mmHg (range 33-49 mmHg) and 46.4 mmHg (range 44-48 mmHg), respectively. The median values of PaO2 and SpO2 during one-lung ventilation were 161.1 mmHg (range 82-206.9 mmHg) and 98% (range 93-99%). The lungs collapsed well, and breathing and circulation remained stable. No complicationarose, and all patients recovered well. These initial findings suggest that non-intubated anesthesia is a safe and straightforward option for MG thymectomy