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Anesthetic Management of the Patient Undergoing Lung Volume Reduction Surgery

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Lung Volume Reduction Surgery
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Abstract

Advances in monitoring, equipment, pharmacologic agents, and perioperative pain management over the past 10 yr have provided the anesthesiologist with new clinical tools, allowing fine adjustment of care to critically ill patients undergoing surgery. The postoperative survival and well being of the patient undergoing lung volume reduction surgery (LVRS) continues to improve owing to perioperative clinical advances. Continuous monitoring of oxygen saturation and end-tidal carbon dioxide allow continual adjustment of intraoperative ventilation. Short-acting anesthetic agents have improved the possibility of early extubation. Intra- and postoperative pain control can be managed on an individual basis in order to optimize ventilation. These changes in clinical management have prevented complications and improved outcome in this critically ill population.

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References

  1. Cottrell JJ, Ferson PF (1992) Preoperative assessment of the thoracic surgical patient. Clin Chest Med 13: 47–53.

    PubMed  CAS  Google Scholar 

  2. Preoperative pulmonary function testing. American College of Physicians. (1990) Ann Intern Med 112: 793–794.

    Google Scholar 

  3. Yusen RD, Lefrak SS, Trulock EP (1997) Evaluation and preoperative management of lung volume reduction surgery candidates. Clin Chest Med 18: 199–224.

    Article  PubMed  CAS  Google Scholar 

  4. McKenna RI Jr, Brenner M, Fischel RJ, Singh N, Yoong B, Gelb AF, Osann KE (1997) Patient selection criteria for lung volume reduction surgery. J Thorac Cardiovasc Surg 114: 957–967.

    Article  PubMed  Google Scholar 

  5. Thurnheer R, Muntwyler J, Stammberger U, Bloch KE, Zollinger A, Weder W, Russi EW (1997) Coronary artery disease in patients undergoing lung volume reduction surgery for emphysema. Chest 112: 122–128.

    Article  PubMed  CAS  Google Scholar 

  6. Bossone E, Martinez FJ, Whyte RI, Iannettoni MD, Armstrong WF, Bach DS (1999) Dobutamine stress echocardiography for the preoperative evaluation of patients undergoing lung volume reduction surgery. J Thorac Cardiovasc Surg 118: 542–546.

    Article  PubMed  CAS  Google Scholar 

  7. Krucylak PE, Naunheim KS, Keller CA, Baudendistel LJ (1996) Anesthetic management of patients undergoing unilateral video-assisted lung reduction for treatment of end-stage emphysema. J Cardiothorac Vasc Anesth 10: 850–853.

    Article  PubMed  CAS  Google Scholar 

  8. Zollinger A, Zaugg M, Weder W, Russi EW, Blumenthal S, Zalunardo MP, Stoehr S, Thurnheer R, Stammberger U, Spahn DR, Pasch T (1997) Video-assisted thoracoscopic volume reduction surgery in patients with diffuse pulmonary emphysema: gas exchange and anesthesiological management. Anesth Analg 84: 845–851.

    PubMed  CAS  Google Scholar 

  9. Triantafillou AN (1996) Anesthetic management for bilateral volume reduction surgery. Semin Thorac Cardiovasc Surg 8: 94–98.

    PubMed  CAS  Google Scholar 

  10. Kalso E, Perttunen K, Kaasinen S (1992) Pain after thoracic surgery. Acta Anaesthesiol Scand 36: 96–100.

    Article  PubMed  CAS  Google Scholar 

  11. Mulder DS (1993) Pain management principles and anesthesia techniques for thoracoscopy. Ann Thorac Surg 56: 630–632.

    Article  PubMed  CAS  Google Scholar 

  12. Richardson J, Sabanathan S, Mearns AJ, Evans CS, Bembridge J, Fairbrass M (1994) Efficacy of pre-emptive analgesia and continuous extrapleural intercostal nerve block on post-thoracotomy pain and pulmonary mechanics. J Cardiovasc Surg (Torino) 35: 219–228.

    CAS  Google Scholar 

  13. Stevens DS, Edwards WT (1991) Management of pain after thoracic surgery. In Kaplan SA, Ed. Thoracic Anesthesia, 2nd Edition, New York: Churchill Livingstone, pp. 563–591.

    Google Scholar 

  14. Johnson WC (1975) Postoperative ventilatory performance: dependence upon surgical incision. Am Surg 41: 615–619.

    PubMed  CAS  Google Scholar 

  15. Shulman M, Sandler AN, Bradley JW, Young PS, Brebner J (1984) Postthoracotomy pain and pulmonary function following epidural and systemic morphine. Anesthesiology 61: 569–575.

    Article  PubMed  CAS  Google Scholar 

  16. Kavanagh BP, Katz J, Sandler AN (1994) Pain control after thoracic surgery. A review of current techniques. Anesthesiology 81: 737–759.

    Article  PubMed  CAS  Google Scholar 

  17. Dahl JB, Kehlet H (1991) Non-steroidal anti-inflammatory drugs: rationale for use in severe postoperative pain. Br J Anaesth 66: 703–712.

    Article  PubMed  CAS  Google Scholar 

  18. Pavy T, Medley C, Murphy DF (1990) Effect of indomethacin on pain relief after thoracotomy. Br J Anaesth 65: 624–627.

    Article  PubMed  CAS  Google Scholar 

  19. Rhodes M, Conacher I, Morritt G, Hilton C (1992) Nonsteroidal antiinflammatory drugs for postthoracotomy pain. A prospective controlled trial after lateral thoracotomy. J Thorac Cardiovasc Surg 103: 17–20.

    PubMed  CAS  Google Scholar 

  20. Sabanathan S, Smith Pi, Pradhan GN, Hashimi H, Eng JB, Mearns AJ (1988) Continuous intercostal nerve block for pain relief after thoracotomy. Ann Thorac Surg 46: 425–426.

    Article  PubMed  CAS  Google Scholar 

  21. Eng J, Sabanathan S (1991) Site of action of continuous extrapleural intercostal nerve block. Ann Thorac Surg 51: 387–389.

    Article  PubMed  CAS  Google Scholar 

  22. Richardson J, Sabanathan S, Eng J, Mearns AJ, Rogers C, Evans CS, Bembridge J, Majid MR (1993) Continuous intercostal nerve block versus epidural morphine for postthoracotomy analgesia. Ann Thorac Surg 55: 377–380.

    Article  PubMed  CAS  Google Scholar 

  23. Majid AA, Hamzah H (1992) Pain control after thoracotomy. An extrapleural tunnel to provide a continuous bupivacaine infusion for intercostal nerve blockade. Chest 101: 981–984.

    Article  PubMed  CAS  Google Scholar 

  24. Deneuville M, Bisserier A, Regnard JF, Chevalier M, Levasseur P, Herve P (1993) Continuous intercostal analgesia with 0.5% bupivacaine after thoracotomy: a randomized study. Ann Thorac Surg 55:381–385.

    Google Scholar 

  25. Burgess FW, Anderson DM, Colonna D, Cavanaugh DG (1994) Thoracic epidural analgesia with bupivacaine and fentanyl for postoperative thoracotomy pain. J Cardiothorac Vasc Anesth 8: 420–424.

    Article  PubMed  CAS  Google Scholar 

  26. Liu S, Angel JM, Owens BD, Carpenter RL, Isabel L (1995) Effects of epidural bupivacaine after thoracotomy. Reg Anesth 20: 303–310.

    PubMed  Google Scholar 

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Delphin, E.S. (2002). Anesthetic Management of the Patient Undergoing Lung Volume Reduction Surgery. In: Argenziano, M., Ginsburg, M.E. (eds) Lung Volume Reduction Surgery. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-121-3_10

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  • DOI: https://doi.org/10.1007/978-1-59259-121-3_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-220-9

  • Online ISBN: 978-1-59259-121-3

  • eBook Packages: Springer Book Archive

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