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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Anesthesia and enhanced recovery in subxiphoid video-assisted thoracoscopic surgery
Zhigang Chen1, Jason M Ali2, Huan Xu1
1Department of Thoracic Surgery and Anaesthesia, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
Abstract:
Subxiphoid video-assisted thoracoscopic surgery (VATS) is a surgical approach in minimally invasive thoracic surgery that aims to aid enhanced recovery by reducing postoperative pain by avoiding instrumentation of the intercostal spaces. Access through a subxiphoid port presents challenges for both the surgeon and anaesthetist. Particularly for left sided procedures, the heart can be compressed resulting in arrhythmia and haemodynamic compromise. The anaesthetic team play an important role in ensuring the success of subxiphoid VATS procedures. The key is continuous and comprehensive monitoring for circulatory disturbance and arrhythmia intraoperatively. Should arrhythmia develop it is important that it is managed rapidly and effectively in such a manner to minimize haemodynamic disturbance. In this article, important considerations for anaesthesia in subxiphoid VATS procedures is presented and solutions presented.
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