{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T22:51:22Z","timestamp":1773096682905,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["7162199"],"award-info":[{"award-number":["7162199"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81372043"],"award-info":[{"award-number":["81372043"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The differences between intravenous and inhalation anesthesia in clinical postoperative pulmonary complications (PPCs) have been studied in cardiac and lung resection surgery. Clinical evidence for the effects of these two anesthetics on PPCs in other types of surgery is still missing. We aimed to assess the impact of sevoflurane and propofol on the incidence of PPCs in patients undergoing surgery for head and neck cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Double\u2010blind, randomized, controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assigned 220 adults at intermediate\u2010to\u2010high risk of PPCs scheduled for head and neck cancer surgery with radial forearm or fibular flap reconstruction to either propofol or sevoflurane as a general anesthetic. The occurrence of pulmonary complications according to the Clavien\u2010Dindo score was defined as the primary (within 7\u2009days after surgery) outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The PPC incidence during 7\u2009days after surgery was 32.4% and 18.2% in the propofol and sevoflurane groups, respectively (<jats:italic>P<\/jats:italic> = .027). The corresponding incidence of PPCs in patients who underwent tracheotomy at the end of surgery in the two groups was 44.8% and 24.5%, respectively (<jats:italic>P<\/jats:italic> = .030). In addition, the Clavien\u2010Dindo classification showed significant differences between groups in minor complications (grades I and II) but not in major complications (grades III\u2013V).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with intravenous anesthesia, the administration of sevoflurane reduces the incidence of minor PPCs (grades I and II) in moderate\u2010 and high\u2010risk patients who have undergone tracheotomy after head and neck cancer surgery with radial forearm or fibular flap reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 131:E108\u2013E115, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28724","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T15:19:25Z","timestamp":1588691965000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Which Anesthesia Regimen Is Best to Reduce Pulmonary Complications After Head and Neck Surgery?"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-974X","authenticated-orcid":false,"given":"Dan","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Peking University Third Hospital  Beijing 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