Introduction Adequate patient position is essential to facilitate surgical exposure. This in turn has direct consequence on the anesthetic management. In addition to providing best access to the patient, optimal position should minimize any potential harm and injuries, especially when…
Introduction Lung cancer accounts for 30% of all cancer cases, with outcomes for patients improving at a modest pace. That said, 5-year survival for patients with stage IA to IIA cancer managed with a combination of chemotherapy and surgery exceeds…
Introduction The main purposes of a comprehensive preoperative evaluation before thoracic surgery are to assess the risk associated with anesthesia and surgery throughout the perioperative period; to identify, modify, and optimize the treatment of comorbidities that may affect perioperative outcome;…
Introduction Thoracic surgery commonly requires the separation of the patient’s airway, followed by exclusion of one lung from ventilation (i.e., one-lung ventilation [OLV]) to facilitate surgical interventions. However, ventilation of one lung will result in an increased intrapulmonary shunt because…
Introduction Thoracic procedures are usually performed with the patient in the lateral decubitus position. To understand the distribution of ventilation and perfusion in the lateral decubitus position and the degree of venous admixture of shunt (Qs/Qt) is expressed as a…
Introduction The practice of thoracic anesthesia, in addition to involving patients with impaired pulmonary function, also necessitates dynamic changes in ventilation that impact perfusion and ventilation/perfusion matching. Thus it is imperative that the thoracic anesthesiologist has a thorough understanding of…
Introduction Thoracic oncology encompasses a large spectrum of diseases. Between the various anatomic spaces and the different organ systems, there are a large variety of benign and malignant tumors that can develop within the chest. This chapter will focus primarily…
Introduction Radiologic images play an important role in the preoperative, intraoperative, and postoperative evaluation, and diagnosis of patients undergoing thoracic surgery. During the preoperative visit for evaluation of the thoracic surgical patient, the clinician must have an understanding of the…
The respiratory and circulatory systems play a major role in the transportation of oxygen from the atmosphere to mitochondria and transportation of carbon dioxide from cells to the atmosphere. They accomplish these tasks by alternate steps of convection and diffusion.…
Introduction The history of anesthesia for thoracic surgery incorporates much of the history of anesthesia because contemporary thoracic anesthesia is a culmination of advances in all aspects of anesthesia. Knowledge and expertise with preoperative evaluation, airway management, intraoperative monitoring, pharmacologic…