Anesthesia for Thoracic Surgery

Abstract

Thoracic surgery and thoracic anesthesia in the pediatric population have changed significantly over the last two decades with the advent of video-assisted thoracoscopic surgery (VATS) and robotic surgery, and evolution of anesthetic practice to facilitate this type of surgery. VATS has significantly decreased the requirement for neuraxial blockade during the intraoperative and postoperative period due to its less invasive and hence less painful nature. This chapter reviews the pathophysiology of one-lung ventilation and discusses the anesthetic practice and tools necessary to facilitate the perioperative management of the pediatric thoracic surgery patient. It also discusses analgesia for thoracic surgery and describes some of the finer nuances of certain specific thoracic surgical challenges within the pediatric population, namely lobectomy, pneumonectomy, congenital cystic lung disease, anterior mediastinal mass, pectus excavatum, and empyema.