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2022 ◽  
Vol 77 ◽  
pp. 110643
Author(s):  
David Lopez-Lopez ◽  
Rocio Mato-Bua ◽  
Alejandro Garcia-Perez ◽  
Anxo Vilar-Castro ◽  
Sara Del-Rio-Regueira

2021 ◽  
Vol 50 (1) ◽  
pp. 508-508
Author(s):  
Erica Chemtob ◽  
David Kauffman ◽  
Connie Nguyen ◽  
Allison Hu ◽  
Raymond Pla ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerome Defosse ◽  
Mark Schieren ◽  
Torsten Loop ◽  
Vera von Dossow ◽  
Frank Wappler ◽  
...  

Abstract Background The scientific working group for “Anaesthesia in thoracic surgery” of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) has performed an online survey to assess the current standards of care and structural properties of anaesthesia workstations in thoracic surgery. Methods All members of the European Society of Anaesthesiology (ESA) were invited to participate in the study. Results Thoracic anaesthesia was most commonly performed by specialists/board-certified anaesthetists and/or senior/attending physicians. Across Europe, the double lumen tube (DLT) was most commonly chosen as the primary device for lung separation (461/ 97.3%). Bronchial blockers were chosen less frequently (9/ 1.9%). Throughout Europe, bronchoscopy was not consistently used to confirm correct double lumen tube positioning. Respondents from Eastern Europe (32/ 57.1%) frequently stated that there were not enough bronchoscopes available for every intrathoracic operation. A specific algorithm for difficult airway management in thoracic anaesthesia was available to only 18.6% (n = 88) of the respondents. Thoracic epidural analgesia (TEA) is the most commonly used form of regional analgesia for thoracic surgery in Europe. Ultrasonography was widely available 93,8% (n = 412) throughout Europe and was predominantly used for central line placement and lung diagnostics. Conclusions While certain „gold standards “are widely met, there are also aspects of care requiring substantial improvement in thoracic anaesthesia throughout Europe. Our data suggest that algorithms and standard operating procedures for difficult airway management in thoracic anaesthesia need to be established. A European recommendation for the basic requirements of an anaesthesia workstation for thoracic anaesthesia is expedient and desirable, to improve structural quality and patient safety.


2021 ◽  
Vol 74 ◽  
pp. 110364
Author(s):  
Rashmi Syal ◽  
Rakesh Kumar ◽  
Swati Chhabra ◽  
Manoj Kamal

Author(s):  
L.I. Levanda ◽  
M.Yu. Shamray ◽  
M.S. Opanasenko ◽  
V.I. Lysenko ◽  
O.V. Tereshkovich ◽  
...  

Objective — to analyze modern anesthetic approaches and their use in endoscopic phthisiosurgery. Materials and methods. During 2008—2021, we performed 133 VATS lung resections in patients with tuberculosis. The following VATS operations were performed: atypical segmentectomy — 29 (21.6 %), typical segmentectomy — 49 (36.9 %), lobectomy — 49 (36.9 %) cases, bilobectomy — 2 (1.5 %), pulmonectomy — 4 (3.1 %) observations.The number of patients diagnosed with newly diagnosed tuberculosis was 62 (46.3 %), with multidrug­resistant tuberculosis 45 (34.4 %) and extensively drug-resistant tuberculosis 26 (19 3 %). One-pulmonary ventilation, which was carried out by endobronchial intubation of the main bronchus of the contralateral lung using a double-lumen tube (DLT) in 115 (86.4 %) patients, in 15 (11.3 %) cases, endobronchial intubation was performed with a single-lumen tube (SLT) and in 3 (3.1 %) tracheal intubation. Results and discussion. The use of a DLT for intubation made it possible to reduce the duration of surgery by 20—25 % compared with the use of a SLT or tracheal intubation. When using a DLT, a more stable, faster and better collapse of the lungs was achieved, which in turn gave a decrease in trauma to its parenchyma due to the fact that additional instrumental actions were not required on the part of surgeons to achieve it.Intraoperative blood loss with DLT was (75.4 ± 38.7) and (112.6 ± 51.8) ml with SLT in experiments with intubation of the main bronchus of the contralateral lung and (184.3 ± 89.8) ml in tracheal intubation, largely due to visualization and comfort working conditions of the surgical team.In the recovery of costs, we adhere to restrictive infusion approaches, which allows avoiding overloading the pulmonary circulation, and therefore reducing the number of pulmonary complications. The qualitative composition of the intraoperative infusion program included crystalloid and colloidal solutions. The quantitative ratio during the intubation of DLT was 3 : 0.5, with SLT 3 : 1. The need for transfusion of blood components was only during tracheal intubation. Conclusions. The most important task of modern anesthesiology in endoscopic phthisiosurgery is to improve patient safety during surgery. The defining technologies of anesthetic protection in this case should be the following categories: means and methods of general anesthesia, methods of respiratory provision and technical means of their application; full intraoperative monitoring of vital functions.


Endoscopy ◽  
2021 ◽  
Author(s):  
Diogo Turiani Hourneaux de Moura ◽  
Bruno Salomão Hirsch ◽  
Mateus Bond Boghossian ◽  
Flaubert Sena de Medeiros ◽  
Thomas R. McCarty ◽  
...  

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