2.2.1. Anesthesia management.
intubated in supine positions, DLTs, atelectasis
ATELECTASIS
Anesthesia induction and maintenance of both groups were performed in the same way. General anesthesia was induced with propofol (1–2 mg/kg) + fentanyl (1 µg/kg) and rocuronium (0.5–1.0 mg/kg). Patients were intubated in supine positions and then placed in a semi-fowler position with arms abducted. Anesthesia maintenance was provided with sevoflurane (1 MAC) and 50% OPatients in the DLT group were blocked on the right side in the standard right procedure and the left side in the left procedure. (With DLTs with male number 39 and female number 37). Accuracy of tube placement was controlled by osculation and fiberoptic analysis if in doubt.Patients in the SLT group were intubated with a normal, single lumen endotracheal tube (number 8.0 for male and number 7.5 for female). The tube position was checked after each repositioning of the patients.In the beginning, mechanical ventilation strategies of the patients were the same in both groups, they were as follows. A frequency of 12 to 15 per minute was adjusted to achieve an end-tidal COIn the SLT group, after thoracoscopic input, the anesthetist was in contact with the surgeon and his lung pressures were reduced until the lowest pressure, where the surgeon’s vision was optimal. The ventilator setting was kept at this pressure, by switching to HFPPV mode under constant fresh flow HFPPV at frequencies that range from 1–1.8 Hz 60–110/min.In the DLT group, the lung on the side to be treated was distinguished from the ventilator and deflated and single lung ventilation was performed with the other lung. Tidal volume reduced to 1 to 2 mL/kg, positive end expiratory pressure 8 cm HAt the end of the surgical procedure, the lungs were observed under thoracoscopy and in the DLT group, double lung was switched, and lung pressures and tidal volumes were manually increased in both groups until there was no atelectasis lung area. After the procedure, all patients were put in supine position and antagonized with standard neostigmine 0.05 mg/kg + atropine 0.01 mg/kg and were dismissed.