title: [Anesthesia for thoracoscopy].
abstract: The thoracoscopy is used both for diagnosis and treatment of pleural and lung diseases. We describe our experience in managing anesthesia for such procedures, the number of which is increasing thanks to technical advances. We review 82 thoracoscopic procedures, 48 of which were video assisted. Sixty-two were performed under balanced general anesthesia (GA) with isoflurane, fentanyl and atracurium. Local anesthesia (LA) with fractionated doses of propofol and fentanyl was used in 20 cases. The mean age of patients receiving LA (63 +/- 17 years) was significantly greater (p < 0.05) than those receiving GA (49 +/- 13 years). ASA IV patients were given LA and sedation. Selective bronchial intubation was performed in 46 cases. Complications during surgery were severe hypoxemia (SpO2 < 85%) requiring suspension of selective lung ventilation in 8 cases, moderate hypoxemia (spO2 < 90% and > 85%) in 1 case, coughing in 3 cases and agitation in 1 case. Video-thoracoscopy is a safe technique that is less invasive than conventional thoracotomy. The number of applications is increasing, although its future place in thoracic surgery must still be determined.
authors.affiliation: Servicio de Anestesiología y Terapéutica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona.
authors.forename: M C
authors.initials: MC
authors.lastname: Unzueta
authors.forename: S
authors.initials: S
authors.lastname: Sabaté
authors.forename: J I
authors.initials: JI
authors.lastname: Casas
authors.forename: J M
authors.initials: JM
authors.lastname: Villar-Landeira
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D000769:Anesthesia, Inhalation; D000772:Anesthesia, Local / Q000379:methods*; D001279:Atracurium; D005260:Female; D005283:Fentanyl; D006801:Humans; D006993:Hypnotics and Sedatives; D007431:Intraoperative Complications / Q000453:epidemiology; D007530:Isoflurane; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D015742:Propofol; D012189:Retrospective Studies; D013906:Thoracoscopy
chemical_list: D006993:Hypnotics and Sedatives; D001279:Atracurium; D007530:Isoflurane; D005283:Fentanyl; D015742:Propofol