Effects of Nonintubated Thoracoscopic Surgery on Postoperative Neurocognitive Function: A Randomized Controlled Trial

Postoperative neurocognitive disorder after thoracoscopic surgery with general anesthesia may be linked to reduced intraoperative cerebral oxygenation and perioperative inflammation, both of which might be exacerbated by mechanical ventilation. This study randomized 110 patients into two groups, intubated and nonintubated, and measured cerebral oxygenation during surgery. Neuroinflammatory biomarkers were measured 24 hours before (as a baseline) and after surgery. Neurocognitive test scores were taken at baseline, 24 hours, and six months after surgery. Cerebral oxygenation during surgery was more stable in the nonintubated group. The nonintubated group had significantly higher neurocognitive test scores at 24 hours and six months. Inflammatory markers were higher in the intubated group. Further, the nonintubated patients had a significantly lower comprehensive complication Index. Nonintubated thoracoscopic surgery appears to offer significant benefits for the patient.