Background
Regional anesthesia (RA) are extensively utilized in lung-resection surgery for pain relief. However, the associations between RA and postoperative pulmonary complications (PPCs) remain inconclusive. Therefore, we aimed to investigate the associations between RA and the incidence of PPCs in adults undergoing lung-resection surgery.
Methods
This retrospective cohort study included adult patients who underwent lung-resection surgery under general anesthesia (GA) at a large comprehensive teaching hospital in China. The primary outcome was PPCs within 7 days.
Results
A total of 9,208 patients were enrolled and assigned into group GA, which received GA alone, or group GA+RA, which received GA combined with RA. Within the GA+RA group, patients were further categorized into the GA + PRA group (GA combined with peripheral regional anesthesia) and the GA + EA group (GA combined with epidural anesthesia). Following matching, the GA+RA group showed a non-significant trend toward lower incidence of PPCs (HR 0.93; 95% CI, 0.86-1.01; p = 0.078). However, a significant decreasing trend was observed in specific subgroups, including patients with a surgical duration ≤ 2 h (HR, 0.74 [0.64-0.86]) and those undergoing thoracoscopic surgery (HR, 0.90 [0.83-0.98]). GA combined with PRA also reduced the risk of postoperative congestive heart failure (HR, 0.37 [0.20-0.68]) and pain (HR, 0.89 [0.84-0.95]).
Conclusions
In this retrospective cohort study, the addition of RA to GA was not associated with a significantreduction in PPCs within 7 days after lung resection compared to GA alone. Exploratory analyses identified potential subgroup-specific benefits that warrant prospective validation.
Trial registration
Chinese Clinical Trial Registry (ChiCTR2400090895).