Anesthetic Management for Pediatric Lung Resection: A Single-Center Retrospective Analysis

Background Lung resection is a complex surgical procedure performed in children to address various pulmonary conditions. The success of this surgical intervention in these patients lies in a multidisciplinary approach, with anesthetic management playing a critical role in ensuring the safety and efficacy of the procedure. Methods After approval by the local ethics committee, clinical data of 17 pediatric patients who underwent lung resection in our hospital from January 2012 to December 2022 were retrospectively analyzed. Results  A total of 16 patients underwent video-assisted thoracoscopic surgery (VATS), and only one patient underwent open thoracotomy. Most indications for this type of procedure are linked to cystic disease at a stage where respiratory function is not severely compromised. Lung resection procedures were conducted under general anesthesia and invasive blood pressure monitoring in all patients. Various methods, such as double-lumen endotracheal tubes (DLTs), bronchial blockers (BBs), and specialized endobronchial devices, were employed to selectively collapse the lung undergoing resection while maintaining ventilation in the contralateral lung. A multimodal analgesia regimen, combining systemic analgesia with regional anesthesia techniques (epidural or regional trunk blocks), was employed. Conclusions Thorough preoperative preparation is critical for a desirable outcome in pediatric patients undergoing lung resection. The need for one-lung ventilation (OLV) presents challenges, especially in younger ages, where this surgery is more commonly performed. The use of BBs is often necessary, along with the likelihood of their extraluminal application. In recent years, to reduce the risks associated with thoracic epidural analgesia, regional trunk blocks have been described as a safe and effective alternative in pain management.