Application and advancement of non-tracheal intubation anesthesia with spontaneous breathing in thoracoscopic surgery

Thoracoscopic surgery requires a relatively static, fully clear surgical field and the leakage test of air needs to adjust the airway pressure, so thoracoscopic surgery is usually performed under general anesthesia with double lumen tracheal intubation in a single lung ventilation. Compared with general anesthesia with double lumen tracheal intubation, non-tracheal intubation anesthesia with spontaneous breathing is more challenging in thoracoscopic surgery, in addition to advantages of a low incidence of postoperative respiratory complications, minor trauma, rapid postoperative recovery, short in operation room stay, hospital stay, etc. Therefore, with improvement of anesthesia and surgical techniques and optimal development of sedation drugs and consumable items of anesthesia in recent years, anesthesia with non-tracheal intubation is gradually applied in thoracoscopic surgery. In this paper, we reviewed the brief history, anesthesia selection, perioperative anesthesia-related issues of thoracoscopic surgery with non-tracheal intubation. Key words: Non-tracheal intubation; Spontaneous breathing; Thoracoscopic surgery