Department of Anesthesia and Intensive Care, AOU Città della Salute e della Scienza, Torino, Italy.
Department of Surgical Science, Anesthesia and Intensive Care Unit, University of Turin, Via Verdi, 8 -, 10124, Torino, Italy.
BMC Anesthesiol. 2022 Jan 3;22(1):2. doi: 10.1186/s12871-021-01514-3.
Non-Intubated Thoracic Surgery (NITS) is becoming increasingly adopted all over the world. Although it is mainly used for pleural operations,, non-intubated parenchymal lung surgery has been less frequently reported. Recently, NITS utilization seems to be increased also in Italy, albeit there are no multi-center studies confirming this finding. The objective of this survey is to assess quantitatively and qualitatively the performance of NITS in Italy.
In 2018 a web-based national survey on Non-Intubated management including both thoracic surgeons and anesthesiologists was carried out. Reference centers have been asked to answer 32 questions. Replies were collected from June 26 to November 31, 2019.
We raised feedbacks from 95% (55/58) of Italian centers. Seventy-eight percent of the respondents perform NITS but only 38% of them used this strategy for parenchymal surgery. These procedures are more frequently carried out in patients with severe comorbidities and/or with poor lung function. Several issues as obesity, previous non-invasive ventilation and/or oxygen therapy are considered contraindications to NITS. The regional anesthesia technique most used to provide intra- and postoperative analgesia was the paravertebral block (37%). Conversion to general anesthesia is not anecdotal (31% of answerers). More than half of the centers believed that NITS may reduce postoperative intensive care unit admissions. Approximately a quarter of the centers are conducting trials on NITS and, three quarters of the respondent suppose that the number of these procedures will increase in the future.
There is a growing interest in Italy for NITS and this survey provides a clear view of the national management framework of these procedures.
非插管式胸部手术（NITS）在全球范围内的应用越来越广泛。虽然它主要用于胸膜手术，但非插管性实质肺手术的报道较少。最近，NITS 在意大利的应用似乎也有所增加，尽管没有多中心研究证实这一发现。本调查的目的是定量和定性评估 NITS 在意大利的应用情况。
2018 年，我们进行了一项基于网络的针对非插管管理的全国性调查，包括胸外科医生和麻醉师。参考中心被要求回答 32 个问题。回复于 2019 年 6 月 26 日至 11 月 31 日收集。
我们收到了意大利 95%（55/58）中心的反馈。78%的受访者采用 NITS，但只有 38%的人将该策略用于实质手术。这些手术更多地用于患有严重合并症和/或肺功能差的患者。肥胖、先前的无创通气和/或氧疗等几个问题被认为是 NITS 的禁忌症。用于提供术中及术后镇痛的区域麻醉技术最常用的是椎旁阻滞（37%）。转为全身麻醉并不罕见（31%的回答者）。超过一半的中心认为 NITS 可能减少术后重症监护病房的住院人数。大约四分之一的中心正在进行 NITS 的试验，四分之三的受访者认为未来这些手术的数量将会增加。
意大利对 NITS 的兴趣日益浓厚，本调查清楚地反映了这些手术的国家管理框架。
