Anesthesia for Thoracic Surgery

Peter Slinger; Javier Campos

doi:10.1016/B978-0-323-93592-0.00049-3

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Book chapter

Anesthesia for Thoracic Surgery

Peter Slinger and Javier Campos

Miller's Anesthesia, 2 Volume Set, pp.1505-1576.e8

Elsevier, Tenth edition

2024

DOI: 10.1016/B978-0-323-93592-0.00049-3

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Abstract

Thoracic anesthesia encompasses a wide variety of diagnostic and therapeutic procedures involving the lungs, airways, and other intrathoracic structures. As the patient population presenting for noncardiac thoracic surgery has evolved, so have the anesthetic techniques to manage these patients. Thoracic surgery at the beginning of the last century was primarily for infectious indications (lung abscess, bronchiectasis, and empyema). Although these cases still present for surgery in the postantibiotic era, now the commonest indications are related to malignancies (pulmonary, esophageal, and mediastinal). In addition, the last two decades have seen the beginnings of surgical therapy for end-stage lung diseases with procedures such as lung transplantation and lung volume reduction. Fundamental to anesthetic management for the majority of thoracic procedures are two techniques: lung isolation to facilitate surgical access within the thorax, and management of one-lung anesthesia. In this chapter we initially discuss pre-anesthetic assessment for thoracic surgery, and then outline intraoperative management principles common to most thoracic surgical procedures. We then discuss specific anesthetic considerations in common and less-common surgical operations, and finish with a description of postoperative management issues in thoracic surgical patients.

Cardiovascular Disease

Abscess/empyema

Acute lung injury

Anesthesia for the patient after lung transplantation

Assessment of respiratory function

Bronchial blockers

Bronchopleural fistula

Bronchopulmonary lavage

Bronchoscopy

Bullectomy

Cardiac herniation

Choice of anesthetic agents

Chronic obstructive pulmonary disease

Double-lumen endobronchial tubes

Endoscopic procedures

Enhanced recovery after thoracic surgery

Esophageal surgery

Extracorporeal membrane oxygenation

Flexible and rigid

Hypoxic pulmonary vasoconstriction

Lung isolation in patients with difficult airways

Lung isolation techniques

Lung transplantation

Lung volume reduction

Management of hypoxemia during one-lung ventilation

Management of one-lung ventilation

Massive hemoptysis

Mediastinal masses

Mediastinoscopy

Nonintubated thoracic surgery

Patient positioning

Perioperative considerations in lung cancer

Physiology of one-lung ventilation

Physiology of the lateral position

Physiotherapy

Postoperative analgesia

Pulmonary resections

Pulmonary thromboendarterectomy

Renal disease

Respiratory failure

Single-lumen endobronchial tubes

Smoking cessation

Standard monitors

Surgical approaches

Tracheal resection

Transesophageal echocardiography

Ventilation techniques

Video-assisted and robotic thoracoscopic surgery

Details

Title: Subtitle: Anesthesia for Thoracic Surgery
Creators: Peter Slinger - University of Toronto
Javier Campos - Perioperative Services, Anesthesia, University of Iowa Health Care, Iowa City, IA, United States
Resource Type: Book chapter
Publication Details: Miller's Anesthesia, 2 Volume Set, pp.1505-1576.e8
Edition: Tenth edition
Publisher: Elsevier; Philadelphia, PA
DOI: 10.1016/B978-0-323-93592-0.00049-3
Language: English
Date published: 2024
Academic Unit: Anesthesia
Record Identifier: 9984825525302771

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