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Anästhesie in der Thoraxchirurgie

  • Martin KleenEmail author
  • Bernhard Zwißler
Living reference work entry

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Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Eingriffe im Thorax betreffen direkt zwei Organsysteme, deren Funktionsstörung nur für kurze Zeit problemlos toleriert wird: das respiratorische und kardiale System. Detailliertes Wissen über die Pathophysiologie von Herz und Lunge ist daher neben der Kenntnis der individuellen (Vor)erkrankungen die grundlegende Vorraussetzung für die kompetente anästhesiologische Versorgung des Patienten in der Thoraxchirurgie. Das Atemwegsmanagement ist wegen der meist erforderlichen Einlungenventilation häufig eine Herausforderung, erfordert Planung und große Erfahrung in der Handhabung des anästhesiologischen Handwerkzeugs. Der Anästhesist ist in der Thoraxchirurgie wegen der relativ hohen postoperativen Komplikationsrate besonders gefordert: überlegtes perioperatives Management mit präoperativer Optimierung, adäquater Schmerztherapie und Narkoseführung können die Frequenz von Komplikationen reduzieren.

Literatur

  1. 1.
    Ashes C, Roscoe A (2015) Transesophageal echocardiography in thoracic anesthesia: pulmonary hypertension and right ventricular function. Curr Opin Anaesthesiol 28:38–44.  https://doi.org/10.1097/ACO.0000000000000138CrossRefPubMedGoogle Scholar
  2. 2.
    Baidya DK, Khanna P, Maitra S (2014) Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg 18:626–635.  https://doi.org/10.1093/icvts/ivt551CrossRefPubMedGoogle Scholar
  3. 3.
    Bassi A, Oliveira Milani WR, El Dib R, Matos D (2008) Intravenous versus inhalation anaesthesia for one-lung ventilation. Cochrane Database Syst Rev 2, CD006313Google Scholar
  4. 4.
    Campos JH (2010) An update on robotic thoracic surgery and anesthesia. Curr Opin Anaesthesiol 23:1–6.  https://doi.org/10.1097/ACO.0b013e3283336547CrossRefPubMedGoogle Scholar
  5. 5.
    Campos J, Ueda K (2014) Update on anesthetic complications of robotic thoracic surgery. Minerva Anestesiol 80:83–88PubMedGoogle Scholar
  6. 6.
    Casati A, Mascotto G, Iemi K, Nzepa-Batonga J, De Luca M (2005) Epidural block does not worsen oxygenation during one-lung ventilation for lung resections under isoflurane/nitrous oxide anaesthesia. Eur J Anaesthesiol 22:363–368CrossRefGoogle Scholar
  7. 7.
    Cason M, Naik A, Grimm JC et al (2014) The efficacy and safety of epidural-based analgesia in a case series of patients undergoing lung transplantation. J Cardiothorac Vasc Anesth.  https://doi.org/10.1053/j.jvca.2014.07.023CrossRefPubMedGoogle Scholar
  8. 8.
    Chen F, Oga T, Sakai H et al (2013) A prospective study analyzing one-year multidimensional outcomes in living lung transplant donors. Am J Transplant 13:3003–3009.  https://doi.org/10.1111/ajt.12476CrossRefPubMedGoogle Scholar
  9. 9.
    Date H, Sato M, Aoyama A et al (2014) Living-donor lobar lung transplantation provides similar survival to cadaveric lung transplantation even for very ill patients†. Eur J Cardiothorac Surg.  https://doi.org/10.1093/ejcts/ezu350CrossRefPubMedGoogle Scholar
  10. 10.
    Davies RG, Myles PS, Graham JM (2006) A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy – a systematic review and meta-analysis of randomized trials. Br J Anaesth 96:418–426.  https://doi.org/10.1093/bja/ael020CrossRefPubMedGoogle Scholar
  11. 11.
    De Conno E, Steurer MP, Wittlinger M et al (2009) Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology 110:1316–1326CrossRefGoogle Scholar
  12. 12.
    Della Rocca G, Coccia C (2005) Nitric oxide in thoracic surgery. Minerva Anestesiol 71:313–318PubMedGoogle Scholar
  13. 13.
    Della Rocca G, Coccia C (2013) Acute lung injury in thoracic surgery. Curr Opin Anaesthesiol 26:40–46.  https://doi.org/10.1097/ACO.0b013e32835c4ea2CrossRefPubMedGoogle Scholar
  14. 14.
    Duthie DJR (2013) Anaesthetic agents for thoracic surgery: what’s best? Curr Opin Anaesthesiol 26:53–57.  https://doi.org/10.1097/ACO.0b013e32835bcff2CrossRefPubMedGoogle Scholar
  15. 15.
    Farkas J-C, Lafon B, Monteau M, Bonnaud G (2007) Lateral decubitus position for life-threatening postpneumonectomy pulmonary edema. Intensive Care Med 33:198–199CrossRefGoogle Scholar
  16. 16.
    Fernández-Pérez ER, Keegan MT, Brown DR, Hubmayr RD, Gajic O (2006) Intraoperative tidal volume as a risk factor for respiratory failure after pneumonectomy. Anesthesiology 105:14–18CrossRefGoogle Scholar
  17. 17.
    Fishman A, Martinez F, Naunheim K et al (2003) A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med 348:2059–2073CrossRefGoogle Scholar
  18. 18.
    Freise H, Aken HKV (2011) Risks and benefits of thoracic epidural anaesthesia. Br J Anaesth 107:859–868.  https://doi.org/10.1093/bja/aer339CrossRefPubMedGoogle Scholar
  19. 19.
    Geddes D, Davies M, Koyama H et al (2000) Effect of lung-volume-reduction surgery in patients with severe emphysema. N Engl J Med 343:239–245CrossRefGoogle Scholar
  20. 20.
    Golianu B, Hammer GB (2005) Pain management for pediatric thoracic surgery. Curr Opin Anaesthesiol 18:13–21CrossRefGoogle Scholar
  21. 21.
    Golianu B, Hammer GB (2005) Pediatric thoracic anesthesia. Curr Opin Anaesthesiol 18:5–11CrossRefGoogle Scholar
  22. 22.
    Gottlieb J, Greer M, Sommerwerck U et al (2014) Introduction of the lung allocation score in Germany. Am J Transplant 14:1318–1327.  https://doi.org/10.1111/ajt.12752CrossRefPubMedGoogle Scholar
  23. 23.
    Hedenstierna G, Tenling A (2005) The lung during and after thoracic anaesthesia. Curr Opin Anaesthesiol 18:23–28CrossRefGoogle Scholar
  24. 24.
    Henry DA, Carless PA, Moxey AJ et al (2007) Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 4, CD001886Google Scholar
  25. 25.
    Hofer CK, Rex S, Ganter MT (2014) Update on minimally invasive hemodynamic monitoring in thoracic anesthesia. Curr Opin Anaesthesiol 27:28–35.  https://doi.org/10.1097/ACO.0000000000000034CrossRefPubMedGoogle Scholar
  26. 26.
    Hung M-H, Hsu H-H, Cheng Y-J, Chen J-S (2014) Nonintubated thoracoscopic surgery: state of the art and future directions. J Thorac Dis 6:2–9PubMedPubMedCentralGoogle Scholar
  27. 27.
    Jakovljevic DG, Trenell MI, MacGowan GA (2014) Bioimpedance and bioreactance methods for monitoring cardiac output. Best Pract Res Clin Anaesthesiol 28:381–394.  https://doi.org/10.1016/j.bpa.2014.09.003CrossRefPubMedGoogle Scholar
  28. 28.
    Johnson RJ, Bradbury LL, Martin K et al (2014) Organ donation and transplantation in the UK-the last decade: a report from the UK national transplant registry. Transplantation 97(Suppl 1):S1–S27.  https://doi.org/10.1097/01.TP.0000438215.16737.68CrossRefPubMedGoogle Scholar
  29. 29.
    Jones NL, Edmonds L, Ghosh S, Klein AA (2013) A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia 68:179–189.  https://doi.org/10.1111/anae.12067CrossRefPubMedGoogle Scholar
  30. 30.
    Karfis EA, Roustanis E, Beis J, Kakadellis J (2008) Video-assisted cervical mediastinoscopy: our seven-year experience. Interact Cardiovasc Thorac Surg 7:1015–1018CrossRefGoogle Scholar
  31. 31.
    Karzai W, Schwarzkopf K (2009) Hypoxemia during one-lung ventilation: prediction, prevention, and treatment. Anesthesiology 110:1402–1411CrossRefGoogle Scholar
  32. 32.
    Kent M, Wang T, Whyte R et al (2014) Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg 97:236–242.  https://doi.org/10.1016/j.athoracsur.2013.07.117; discussion 242–244CrossRefPubMedGoogle Scholar
  33. 33.
    Klijian AS, Gibbs M, Andonian NT (2014) AVATS: Awake Video Assisted Thoracic Surgery –extended series report. J Cardiothorac Surg.  https://doi.org/10.1186/s13019-014-0149-xCrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Kneidinger N, Holzborn J, Czerner S et al (2014) Evaluation of short-term outcome after lung transplantation in the lung allocation score era. Thorac Cardiovasc Surg.  https://doi.org/10.1055/s-0034-1387821CrossRefPubMedGoogle Scholar
  35. 35.
    Knoll H, Ziegeler S, Schreiber JU et al (2006) Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker. Anesthesiology 105:471–477CrossRefGoogle Scholar
  36. 36.
    Kozian A, Schilling T, Hachenberg T (2005) Non-analgetic effects of thoracic epidural anaesthesia. Curr Opin Anaesthesiol 18:29–34CrossRefGoogle Scholar
  37. 37.
    Kozian A, Kretzschmar MA, Schilling T (2015) Thoracic anesthesia in the elderly. Curr Opin Anaesthesiol 28:2–9.  https://doi.org/10.1097/ACO.0000000000000152CrossRefPubMedGoogle Scholar
  38. 38.
    Liu J, Cui F, Li S et al (2014) Nonintubated video-assisted thoracoscopic surgery under epidural anesthesia compared with conventional anesthetic option: a randomized control study. Surg Innov.  https://doi.org/10.1177/1553350614531662CrossRefPubMedGoogle Scholar
  39. 39.
    Maxwell BG, Mooney JJ, Lee PHU et al (2014) Increased resource utilization in lung transplant admissions in the lung allocation score era. Am J Respir Crit Care Med.  https://doi.org/10.1164/rccm.201408-1562OCCrossRefGoogle Scholar
  40. 40.
    Maxwell C, Nicoara A (2014) New developments in the treatment of acute pain after thoracic surgery. Curr Opin Anaesthesiol 27:6–11.  https://doi.org/10.1097/ACO.0000000000000029CrossRefPubMedGoogle Scholar
  41. 41.
    Mungroop HE, Tjong Yoe Wai P, Morei MN et al (2010) Lung isolation with a new Y-shaped endobronchial blocking device, the EZ-Blocker. Br J Anaesth 104:119–120CrossRefGoogle Scholar
  42. 42.
    Pompeo E (2014) State of the art and perspectives in non-intubated thoracic surgery. Ann Transl Med.  https://doi.org/10.3978/j.issn.2305-5839.2014.10.01CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Pompeo E (2014) Nonintubated video-assisted thoracic surgery under epidural anesthesia – encouraging early results encourage randomized trials. Chin J Cancer Res 26:364–367.  https://doi.org/10.3978/j.issn.1000-9604.2014.07.06CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Van Raemdonck D, Neyrinck A, Cypel M et al (2015) Ex-vivo lung perfusion. Transpl Int 28:643-65640. Rex S, Missant C, Segers P, Wouters PF (2007) Thoracic epidural anesthesia impairs the hemodynamic response to acute pulmonary hypertension by deteriorating right ventricular-pulmonary arterial coupling. Crit Care Med 35:222–229Google Scholar
  45. 45.
    Rich JD, Rich S (2014) Clinical diagnosis of pulmonary hypertension. Circulation 130:1820–1830.  https://doi.org/10.1161/CIRCULATIONAHA.114.006971CrossRefPubMedGoogle Scholar
  46. 46.
    Richardson J, Lönnqvist PA, Naja Z (2011) Bilateral thoracic paravertebral block: potential and practice. Br J Anaesth 106:164–171CrossRefGoogle Scholar
  47. 47.
    Ruttens D, Verleden SE, Vandermeulen E et al (2014) Body mass index in lung transplant candidates: a contra-indication to transplant or not? Transplant Proc 46:1506–1510.  https://doi.org/10.1016/j.transproceed.2014.04.004CrossRefPubMedGoogle Scholar
  48. 48.
    Schilling T, Kozian A, Huth C, Bühling F, Kretzschmar M, Welte T, Hachenberg T (2005) The pulmonary immune effects of mechanical ventilation in patients undergoing thoracic surgery. Anesth Analg 101:957–965CrossRefGoogle Scholar
  49. 49.
    Schilling T, Kozian A, Senturk M, Huth C, Reinhold A, Hedenstierna G, Hachenberg T (2011) Effects of volatile and intravenous anesthesia on the alveolar and systemic inflammatory response in thoracic surgical patients. Anesthesiology 115:65–74CrossRefGoogle Scholar
  50. 50.
    Sugasawa Y, Yamaguchi K, Kumakura S et al (2011) The effect of one-lung ventilation upon pulmonary inflammatory responses during lung resection. J Anesth 25:170–177CrossRefGoogle Scholar
  51. 51.
    Thomsen T, Villebro N, Møller AM (2014) Interventions for preoperative smoking cessation. Cochrane Database Syst Rev 3, CD002294.  https://doi.org/10.1002/14651858.CD002294.pub4CrossRefGoogle Scholar
  52. 52.
    Tiong LU, Davies R, Gibson PG et al (2006) Lung volume reduction surgery for diffuse emphysema. Cochrane Database Syst Rev 4, CD001001Google Scholar
  53. 53.
    Trela-Stachurska K, Nestorowicz A, Kotlińska-Hasiec E et al (2015) Effects of unilateral PEEP on biomechanics of both lungs during independent lung ventilation in patients anaesthetised for thoracic surgery. Anaesthesiol Intensive Ther 47:1–6CrossRefGoogle Scholar
  54. 54.
    Wink J, Veering BT, Aarts LPHJ, Wouters PF (2014) Effect of increasing age on the haemodynamic response to thoracic epidural anaesthesia: an observational study. Eur J Anaesthesiol 31:597–605.  https://doi.org/10.1097/EJA.0000000000000125CrossRefPubMedGoogle Scholar
  55. 55.
    Zwißler B (2000) Das akute Rechtsherzversagen. Anaesthesist 49:788–808CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.INCCI, Institut National de Chirurgie CardiaqueLuxembourgLuxembourg
  2. 2.Klinikum der Universität München, Klinik für AnästhesiologieMünchenDeutschland

Section editors and affiliations

  • Bernhard Zwißler
    • 1
  1. 1.Klinikum der Universität München, Klinik für AnästhesiologieMünchenGermany

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