Exploratory research of the anesthetic method for straight tubeshaped tracheal stent implantation

Abstract:
Objective: To explore research on the security and effect of conscious sedation combined with local anesthesia used for tracheal stent implantation, the operation of which has strong stimulation and a high rate of hypoxemia. Methods: Thirty-four patients scheduled for straight tube-shaped tracheal stent implantation were randomly divided into the following 2 groups (n=17 each): control group (LA); and the observation group (LA+CS). The LA group received local anesthesia alone. The LA+CS group received a combination of local anesthesia with conscious sedation. Anesthetic and operative times were recorded and the anesthetic efficacy was evaluated. MAP, HR, SPO2, BIS, and anesthetic complications were recorded before anesthesia (T0), before surgery (T1), when the ventilation catheter passed through the glottis (T2), when the tracheal stent passed through the glottis (T3), when the tracheal stent was released (T4), and 2 min post-operatively (T5). Results: The operative time in the LA+CS group was less than the LA group (P<0.05), but the anesthetic time was not significantly different between the two groups (P>0.05). The rates of excellent and good anesthetic efficacy in the LA+CS group were significantly greater than the LA group (P<0.01), and the rate of good anesthetic efficacy in the LA+CS group was greater than the LA group (P<0.05) and the rate of bad anesthetic efficacy in the LA+CS group was less than the LA group (P<0.05). The MAP from T2-to-T4, HR at T3, and BIS from T1-to-T4 in the LA+CS group were less than the LA group (P<0.05 or P<0.01). The coughing and bad memories rates in the LA+CS group were significantly less than the LA group (P<0.01). No body movement rate in the LA+CS group was greater than the LA group (P<0.01) and the extreme body movement rate in the LA+CS group was less than the LA group (P<0.05). The nausea, respiratory depression, airway spasm, and pharyngeal discomfort rate were not significantly different between the two groups (P>0.05). The MAP in the LA group from T2-to-T5 were higher than at T0 (P<0.01) and the MAP in the LA+CS group at T1 was less than at T0 (P<0.01). The HR in the LA group from T2-to-T5 was greater than at T0 (P<0.01 or P<0.05) and the HR in the LA group at T1 was less than at T0 (P<0.05). The SPO2 in the two groups at T3 was less than at T0 (P<0.01) and the SPO2 in the two groups at T5 was greater than at T0 (P<0.01). The BIS in the LA+CS group from T1-to-T4 was less than at T0 (P<0.01). Conclusion: Local anesthesia combined with conscious sedation for tracheal stent implantation is an effective method which has better anesthetic efficacy, less hemodynamic fluctuation, and lower coughing, bad memories, and extreme body movement rates. Local anesthesia combined with conscious sedation for tracheal stent implantation does not affect turnover and is worthy of clinical promotion.