[Lung function changes during anesthesia and thoracic surgery].
After anaesthesia and thorax surgery, a significant reduction in pulmonary function with up to a 50% decrease in FEV1, FVC, and FRC is seen, leading to a high risk of atelectasis and hypoxia, and therefore making respiratory complications the major course of perioperative morbidity and mortality in this group of patients. This severe reduction in lung function gradually diminishes within three weeks, but postoperative pain and sedation increase the deterioration in lung function, and treatment is therefore based on anaesthetic drugs with a short elimination time and effective postoperative pain treatment with epidural analgesia or other regional blockade, and minimal use of opioids. Together with more sparing surgical methods, it is possible to operate on patients with severely reduced preoperative lung function (FEV1 = 0.651 or 22% of predicted value) with lung resection and immediate extubation. A reduction in pulmonary complications after thoracic surgery from 25-30% down to 10-15% is also seen, depending on age and preoperative lung function.
Bigler
Dennis R
DR
Anaestesiologisk afdeling, Amtssygehuset i Gentofte, DK-2900 Hellerup.
D000768:Anesthesia, General / Q000009:adverse effects; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008176:Lung Volume Measurements; D011183:Postoperative Complications / Q000503:physiopathology* / Q000517:prevention & control; D012115:Residual Volume / Q000502:physiology; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D014797:Vital Capacity / Q000502:physiology