• Ethan Y Brovman, Andres Zorrilla-Vaca, and Richard D Urman.
• Department of Anesthesiology, and Perioperative Medicine, Tufts Medical Center, Boston, MA.
• J. Cardiothorac. Vasc. Anesth. 2023 Apr 1; 37 (4): 547554547-554.

ObjectiveTo determine whether general anesthesia (GA) in conjunction with regional anesthetic (RA) techniques are associated with favorable pulmonary outcomes versus GA alone among patients undergoing lobectomy by either video-assisted thoracoscopic surgery (VATS) or open thoracotomy.DesignA retrospective cohort (2014-2017).SettingThe American College of Surgeons National Surgical Quality Improvement Program.ParticipantsAdult patients undergoing lobectomy by either VATS or open thoracotomy.InterventionsTwo groups of patients were identified based on the use of GA alone or GA in conjunction with RA (RA+GA) techniques (either neuraxial or peripheral nerve blocks). Both groups were propensity-matched based on pulmonary risk factors. The authors' primary outcome was composite postoperative pulmonary complication (PPC), including pneumonia, reintubation, and failure to wean from the ventilator.Measurements And Main ResultsA total of 4,134 VATS (2,067 in GA and 2,067 in RA+GA) and 3,112 thoracotomies (1,556 in GA and 1,556 in RA+GA) were included in the final analysis. Regional anesthetic, as an adjuvant to GA, did not affect the incidence of PPC among patients undergoing lobectomy by VATS (odds ratio [OR] 1.07, 95% CI 0.81-1.43, p = 0.622), as well as in those undergoing lobectomy via thoracotomy (OR 1.19, 95% CI 0.93-1.51, p = 0.174). There was no statistically significant difference between groups in terms of readmission rates, length of stay, and mortality at 30 days.ConclusionsThe RA techniques were not associated with a lower incidence of pulmonary complications in lobectomy surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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