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Video-assisted thoracic surgery utilizing local anesthesia and sedation
1Geisinger Wyoming Valley Medical Center, 1000 East Mountain Drive, Wilkes-Barre, PA 18711, USA. mrkatlic@geisinger.edu
Summary
Video-assisted thoracic surgery (VATS) using local anesthesia and sedation is safe and effective for various procedures. This approach broadens VATS indications, offering a well-tolerated alternative to general anesthesia.
Area of Science:
- Thoracic Surgery
- Anesthesiology
- Minimally Invasive Procedures
Background:
- Video-assisted thoracic surgery (VATS) traditionally uses general anesthesia and double-lumen intubation.
- Some minor procedures have utilized spontaneous breathing with regional analgesia.
- This study explores expanding VATS indications with local anesthesia and sedation.
Purpose of the Study:
- To evaluate the safety and efficacy of VATS performed under local anesthesia and sedation.
- To determine the range of indications suitable for this anesthetic approach.
- To assess patient tolerance and outcomes.
Main Methods:
- Retrospective review of medical records for VATS procedures under local anesthesia and sedation.
- Procedures performed between July 2002 and June 2006.
- Patients maintained in lateral position without endotracheal intubation or epidural/nerve block analgesia.
Main Results:
- 115 patients underwent 126 VATS procedures, including pleural biopsy, effusion drainage, empyema drainage, lung biopsy, and others.
- No patient required intubation or conversion to thoracotomy.
- Three patients died from underlying diseases; one experienced transient renal insufficiency.
Conclusions:
- VATS with local anesthesia and sedation is well-tolerated and safe.
- This anesthetic technique is valuable for an expanding range of thoracic surgery indications.
- It offers a viable alternative to general anesthesia for selected patients.