A decade later similar nerve block analgesia was used with modern fiberoptic equipment in patients with malignant effusions, and spontaneous pneumothorax and epidural analgesia has been employed for pulmonary nodules and pneumothorax. In 1987 Rusch and Mountain used multiple intercostal blocks and a standard mediastinoscope for diagnosis and treatment of pleural problems in 46 patients. There have been reports of VATS utilizing less than general anesthesia, often for pleural disease. Some operations, however, do not require general anesthesia and endotracheal intubation, and there are risks to such anesthesia. The advent of safe general anesthesia, fiberoptic telescopes, and small stapling devices enabled present-day video-assisted thoracic surgery (VATS), including pulmonary lobectomy, esophagectomy, thymectomy, and other procedures. Ferdinand Sauerbruch, regarding surgery prior to 1914įor 80 years thoracoscopy was performed through hollow tubes under local anesthesia. Conclusion: VATS utilizing local anesthesia and sedation is well tolerated, safe, and valuable for an increasing number of indications. One patient developed transient renal insufficiency attributed to ketorolac. Three patients who underwent lung biopsy died of their underlying disease (cytomegalovirus and pneumocystis, primary amyloidosis, metastatic cancer to contra-lateral lung) on postoperative days 18, 14, and 4, respectively. No patient required intubation or conversion to thoracotomy.
Results: One hundred and fifteen patients, ranging in age from 21 to 88 years and in size from 40 to 172 kg, underwent 126 video-assisted thoracic operations: pleural biopsy/effusion drainage with or without talc 81, drainage of empyema 21, lung biopsy 18, evacuate hemothorax 3, pericardial window 2, biopsy chest wall mass 1.
#Valley anesthesia memory master full
All procedures were performed in the operating room with patients in full lateral position no patient had endotracheal intubation or epidural or nerve block analgesia.
Methods: The medical records of all patients undergoing VATS under local anesthesia and sedation at Geisinger Wyoming Valley Medical Center between 7/1/02 and 6/1/06 were reviewed. We have broadened our indications for VATS utilizing purely local anesthesia and sedation. Objective: Video-assisted thoracic surgery (VATS) is usually performed with general anesthesia and double-lumen endotracheal intubation, but minor procedures have been carried out with patients spontaneously breathing and with epidural or regional analgesia.
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