[Per- and postoperative risk status in pulmonary surgery].

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Respiratory Physiology

Background:

• Advances in understanding pulmonary physiology have improved surgical outcomes.
• One-lung anesthesia enhances patient safety and surgical conditions during pulmonary procedures.
• Hypoxic episodes are minimized with current anesthetic and ventilatory strategies.

Purpose of the Study:

• To highlight the advancements in managing gas exchange during pulmonary surgery.
• To emphasize the importance of invasive monitoring and advanced ventilation techniques.
• To discuss the benefits of epidural thoracic analgesia for postoperative recovery.

Main Methods:

• Implementation of one-lung anesthesia.
• Utilization of comprehensive invasive monitoring, including central venous pressure, pulmonary pressures, and radial arterial pressure.
• Application of pulse oximetry and end-tidal carbon dioxide monitoring.
• Frequent arterial blood gas analysis for ventilation adjustments.
• Placement of thoracic epidural catheters for postoperative analgesia.

Main Results:

• Improved control of gas exchange during pulmonary surgery.
• Enhanced patient safety and surgical conditions with one-lung anesthesia.
• Avoidance of intraoperative hypoxic episodes.
• Effective management of ventilation for both dependent and independent lungs.
• Facilitation of rapid and complete pulmonary function recovery post-surgery with epidural analgesia.

Conclusions:

• Modern pulmonary surgery benefits significantly from one-lung anesthesia and invasive monitoring.
• Continuous monitoring and precise ventilation adjustments are crucial for optimal outcomes.
• Thoracic epidural analgesia is a key factor in accelerating postoperative recovery of pulmonary function.