Thoracic Anesthesia in the Developing World
Patients presenting for thoracic surgeries in the developing world may often suffer from tuberculosis, pyogenic, and parasitic infections. These may be associated with chronic malnourishment and anemia. Patients with empyema may be complicated with an underlying bronchopleural fistula, in whom a history of position-related productive cough should be sought. Thoracic surgery for infectious conditions is more likely to develop intraoperative bleeding. Judicious use of antimicrobial agents, in addition to respiratory physiotherapy, including muscle strengthening exercises, helps to improve the cardiorespiratory status of the patient. Surgical and anesthesia practices are often modified to strike a balance between available resources and optimizing patient outcomes. The choice of lung isolation technique may often depend on the availability of devices and expertise. In the absence of a pediatric bronchoscope, double-lumen tubes are often preferred over bronchial blockers, as they can be inserted blindly and their position can be confirmed by clinical methods.
KeywordsThoracic anesthesia Anesthesia in the developing world Anesthesia for tuberculosis patients
We thank Dr. Anila Malde, Professor, Department of Anesthesia, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India, for her valuable inputs.
We thank Dr. Sandeep Tandon, Dr. Maheema Bhaskar, and Dr. Aparna Iyer, Chest Physicians, Pulmonary Medicine Unit, Tata Memorial Hospital, India, for providing the images.
We thank Dr. Amit Janu, Consultant Radiologist, Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India, for reporting the images.
Conflicts of Interest
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