[Role of peridural anesthesia in thoracic surgery]

Periduralaneaesthesia by the cervical route (C6-C7 or C7-D1) or by the upper lumbar route with an ascending catheter, permit thoracic surgery in all its applications. The reduction in operative bleeding is an appreciable advantage of the method, and automatic nervous stability is remarkable. On the other hand, keeping the patient in the waking state is a definite disadvantage, especially in removal of one lung. As far as the anaesthetist is concerned he will be faced with difficulties of ventilation and bronchial aspiration. On the other hand, combined with slight general anaesthesia and tracheal intubation, peridural anaesthesia is definitely of interest. Furthermore, during the post-operative period, it is precious permitting a cough without pain and, in this respect, the comparison with anaesthesia of the inter-costal nerves, is worth discussins, each technique having special advantages.