Mier-Odriozola JM

Language: Spanish
References: 8
Page: 228-230
PDF size: 57.26 Kb.

ABSTRACT

Non-intubated thoracic surgery entails procedures performed through regional anesthesia method in awake or mildly sedated, spontaneously ventilating patients. This method represents advantages for the cardiovascular system, and reduces the orotracheal trauma, postoperative atelectasis, and pneumonia. It also possibly reduces costs. Other theoretical advantages are: easier acceptance of surgery, attenuated stress hormone and immune response, and possibly a better survival in oncological surgery. We show a 34-year-old woman with sever palmar-axillary hyperhidrosis. We performed the procedure with local anesthesia (ropivacaine 2 mg/ml) 5 ml in each wound trocar; 20 ml inside the thoracic cavity. The patient was mildly sedated with fentanyl and dexmedetomidine. The procedure was very simple, the patient was included in an outpatient program 90 minutes after the surgery. We conclude that sympathectomy with a non-intubated patient is safe and could be the beginning of other kinds of more complex procedures.

REFERENCES

1. Pompeo E. State of the art and perspectives in non-intubated thoracic surgery. Ann Transl Med. 2014;2(11):106.

2. Pompeo E, Mineo TC. Awake thoracic surgery: a historical perspective. En: Pompeo E, ed. Awake thoracic surgery. eBook. Sharjah, Emiratos Árabes Unidos: Benthman Science Publishers; 2012. p. 3-8.

3. Chen KC, Cheng YJ, Hung MH, Tseng YD, Chen JS. Nonintubated thoracoscopic surgery using regional anesthesia and vagal block and targeted sedation. J Thorac Dis. 2014;6(1):31-6.

4. Groeben H. Epidural anesthesia and pulmonary function. J Anesth. 2006;20(4):290-9.

5. Katlic MR, Facktor MA. Video-assisted thoracic surgery utilizing local anesthesia and sedation: 384 consecutive cases. Ann Thorac Surg. 2010;90(1):240-5.

6. Pompeo E, Rogliani P, Tacconi F, et al. Randomized comparision of awake nonresectional versus nonawakeresectional lung volume reduction surgery. J Thorac Cardiovasc Surg. 2012;143(1):47-54.

7. Pompeo E, Mineo D, Rogliani P, Sabato AF, Mineo TC. Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodule. Ann Thorac Surg. 2004;78(5):1761-8.

8. Liu J, Cui F, Li S, et al. Nonintubated video-assisted thoracoscopic surgery under epidural anesthesia compared with conventional anesthesic option: a randomized control study. Surg Innov. 2015;22(2): 123-30.