Background and Goal of Study: Un-planned critical care admission is a devastating complication of lung resection. Within the UK Association of Cardiothoracic Anaesthesia and Critical Care's annual collaborative audit into Critical care Admission following Lung Resection (CALoR) we sought to investigate the influence
of anaesthetic and analgesic techniques on the need for unplanned post-operative critical care. Materials and Methods: This was a multicentre retrospective audit examining adult patients undergoing lung resection in the years 2013-2014. Sixteen UK thoracic centres contributed to the audit where demographic and clinical data was collected on every patient fulfilling inclusion criteria. Control data was
collected from a minimum of three consecutive contemporaneous control patients undergoing surgery prior to each case. Association was sought between mode of anaesthesia (total intravenous anaesthesia (TIVA) vs volatile) and analgesic technique (epidural vs paravertebral) and need for critical care admission. Multivariate regression analyses was performed on a 'complete case' basis and following multiple
imputation by chained equations. Results and Discussion: Sufficient data for analysis was available from 7,431 patients; 7178 controls and 253 cases. There was a strong and significant effect of both anaesthetic and analgesic technique on need for critical care admission. Patients receiving TIVA were estimated to have approximately half the odds of admission compared to these undergoing volatile anaesthesia, whilst patients receiving epidural analgesia had just over half the odds of admission compared to those receiving paravertebral (Table 1).

04 / Critical care after lung resection - Influence of anaesthetic and analgesic technique