Advertisement

Anaesthesia for Uniportal VATS

  • Sonia Alvarado
  • César BonomeEmail author
  • Diego Gonzalez-Rivas
Chapter

Abstract

With the emergence of video-assisted thoracic surgery and more recently, thoracic surgery performed through a single incision (uniportal video-assisted thoracoscopic surgery) we have witnessed a move towards less aggressive thoracic procedures which lead us to search for minimally invasive surgical approaches and more secure anaesthesic strategies, always trying to decrease secondary injuries. However, anaesthesiologists should not believe that this necessarily implies safer or more simple procedures. In fact, anaesthesia for video-assisted thoracic surgery, requires the same level of monitoring and security than conventional open surgeries.

Success resides not only in a sophisticated surgical technique but also in an adequate anaesthetic management which includes a correct selection of the patients, a suitable and personalized patient monitoring, a safe airway management, and an efficient postoperative analgesia strategy.

References

  1. 1.
    Shaw JP, Dembitzer FR, Wisnivesky JP, Litle VR, Weiser TS, Yun J, et al. Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg. 2008;85(2):S705–9.CrossRefGoogle Scholar
  2. 2.
    Gónzalez-Rivas D, Aymerich H, Bonome C, Fieira E. From open operations to nonintubated video-assisted thoracoscopic lobectomy: minimizing the trauma to the patient. Ann Thorac Surg. 2015;100(6):2003–5.CrossRefGoogle Scholar
  3. 3.
    Matsuguma H, Nakahara R, Anraku M, Kondo T, Tsuura Y, Kamiyama Y, et al. Objective definition and measurement method of ground-glass opacity for planning limited resection in patients with clinical stage IA adenocarcinoma of the lung. Eur J Cardiothorac Surg. 2004;25:1102–6.CrossRefGoogle Scholar
  4. 4.
    Gothard J. Lung injury after thoracic surgery and one-lung ventilation. Curr Opin Anaesthesiol. 2006;19(1):5–10.CrossRefGoogle Scholar
  5. 5.
    Brassard C, Lohser J, Donati F, Bussières J. Step-by-step clinical management of one-lung ventilation: continuing professional development. Can J Anesth. 2014;61:1103–21.CrossRefGoogle Scholar
  6. 6.
    Nagendran J, Stewart K, Hoskinson M, Archer SL. An anesthesiologist’s guide to hypoxic pulmonary vasoconstriction: implications for managing single-lung anesthesia and atelectasis. Curr Opin Anaesthesiol. 2006;19(1):34–43.CrossRefGoogle Scholar
  7. 7.
    Hausman MS Jr, Jewell ES, Engoren M. Regional versus general anesthesia in surgical patients with chronic obstructive pulmonary disease: does avoiding general anesthesia reduce the risk of postoperative complications? Anesth Analg. 2014;120(6):1405–12.CrossRefGoogle Scholar
  8. 8.
    Katlic MR, Facktor MA. Video-assisted thoracic surgery utilizing local anesthesia and sedation: 384 consecutive cases. Ann Thorac Surg. 2010;90(1):240–5.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Sonia Alvarado
    • 1
  • César Bonome
    • 1
    Email author
  • Diego Gonzalez-Rivas
    • 2
    • 3
  1. 1.Anesthesiology DepartmentUniversity Hospital La CoruñaLa CoruñaSpain
  2. 2.Department of Thoracic Surgery, Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina
  3. 3.Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI)Coruña University HospitalCoruñaSpain

Personalised recommendations