A Prospective Clinical Study Observed the Effects of Tubeless Anesthesia Method That Preserves Spontaneous Breathing and the Double-lumen Bronchial Intubation on the Brain Health During the Perioperative Period

Inclusion criteria

• Patient age: 18 - 75 years old
• Patients meeting the standards of the American Society of Anesthesiologists (ASA) I-III grade and the New York Heart Association (NYHA) I-II class
• Body Mass Index (BMI) < 30 kg/m2
• Intraoperative blood loss less than 300 ml
• No severe cardiac or pulmonary dysfunction [first-second forced vital capacity (FEV1%) predicted value] > 50%, ejection fraction (EF) > 50%
• No contraindications related to paravertebral nerve block and intercostal nerve block
• Able to sign the informed consent form and possess communication, reading and writing abilities
• Postoperative hospital stay of at least one day
• No preoperative sleep disorders, no cognitive dysfunction (PSQI ≤ 10 points, PCS ≤ 38 points, MMSE > 27 points)

Exclusion criteria

• Already diagnosed with a mental disorder or had a preoperative Mini-Mental State Examination (MMSE) score of less than 27
• History of opioid abuse
• Patients who were admitted to the ICU after surgery
• Have severe cardiovascular, respiratory diseases
• Experienced critical rescue during or after the surgery
• Complicated with coagulation dysfunction, severe hypoxia or hypercapnia, or liver and kidney dysfunction
• Difficult airway management
• Changed anesthetic agent or surgical plan
• Severe lacunar cerebral infarction, ischemic stroke or other neurological diseases
• Changed anesthetic agent or surgical plan during the surgery;