[A nationwide survey of anesthesia for laparoscopic and thoracoscopic surgeries]

This is the report the first nationwide survey of anesthetic management for laparoscopic and thoracoscopic surgeries. We mailed a questionnaire to anesthetists of 133 hospitals in Japan and 74 completed questionnaires were returned. The number of intra-abdominal and thoracic surgical procedures has been increasing. General anesthesia was used in all cases for endoscopic surgery. The double lumen tube was selected in 79% of patients with pneumothorax for the endobronchial intubation. Patients for the laparoscopic cholecystectomy (LC) were given various types of anesthetics. Thirty-two percent of patients who underwent LC was anesthetized with inhalation anesthetics combined with epidural anesthesia for the early ambulance and postoperative pain control. The maximum length of time for LC surgery was 12.5 hr. Complications related to laparoscopic surgery included bile duct injuries in 72 patients, postoperative bleeding in 32 patients, vascular injuries in 29 patients, pneumothorax in 26 patients, bronchial intubation in 17 patients, gas embolism in 11 patients, bowel injuries in 9 patients and postoperative ileus in 7 patients. Administering anesthesia for endoscopic procedures requires precise knowledge of the surgical procedures, physiologic changes and complications of the pneumoperitoneum, and one lung ventilation.