Anesthesia Comparison in Early-stage Small NSCLC: A Multicenter RCT

Inclusion criteria

• Age ≤ 75 years;
• Gender is not limited;
• Patients with suspected T1 stage non-small cell lung cancer (NSCLC) in preoperative clinical staging, with thin-slice CT showing that the maximum tumor diameter is ≤ 3.0 cm, single or multiple nodules, and the nodules requiring surgical resection are located in the same ipsilateral lung lobe, with the number of nodules resected simultaneously ≤ 3;
• American Society of Anesthesiologists (ASA) classification ≤ Grade III (preferably Grade I - II is recommended);
• Eastern Cooperative Oncology Group (ECOG) performance status 0 - 1;
• Body Mass Index (BMI) < 25 kg·m-²;
• Normal cardiopulmonary function: predicted forced expiratory volume in the first second (FEV1%) > 50%, resting blood gas analysis showing arterial oxygen partial pressure (PaO2) ≥ 75 mmHg, arterial carbon dioxide partial pressure (PaCO2) < 45 mmHg; ejection fraction (EF) > 50%, 6-minute walk distance (6MWD) ≥ 350 m;
• No severe upper airway lesions, Mallampati classification I - II;
• No contraindications related to paravertebral nerve block and intercostal nerve block;
• Estimated surgical time ≤ 150 minutes;
• Patients have no history of clinically significant cardiac or neurological problems.

Exclusion criteria

• A history of ipsilateral lung surgery;
• Interstitial pneumonia, pulmonary fibrosis, severe emphysema, severe chronic obstructive pulmonary disease, acute phase of pulmonary infection, or uncontrolled asthma;
• Sleep apnea syndrome with anticipated airway difficulty or difficulty in airway management;
• Preoperative complications including coagulation dysfunction, hypoxemia, hypercapnia, or hepatic/renal insufficiency;
• Alteration of anesthesia or surgical plan;
• Persistent cough or increased risk of high airway secretion reflux;
• Mental disorders, inability to communicate, or refusal to sign the informed consent form;
• Participation in other clinical trials within 1 month before this trial;
• Those who are deemed unfit to participate in this trial by the researchers.