Successful use of regional anesthesia in non-intubated video-assisted thoracic surgery in patients with cardiopulmonary failure: two case reports
| Autor: | Shigehito Sawamura, Haruna Yamamoto, Satoru Kayama |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Pleural effusion Regional anesthesia Case Report 030204 cardiovascular system & hematology lcsh:RD78.3-87.3 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Anesthesiology medicine Local anesthesia Paravertebral Block Video-assisted thoracic surgery (VATS) Paravertebral block (PVB) business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 medicine.disease Empyema Anesthesiology and Pain Medicine Respiratory failure Cardiothoracic surgery Cardiopulmonary failure lcsh:Anesthesiology Anesthesia Breathing Non-intubated business |
| Zdroj: | JA Clinical Reports, Vol 4, Iss 1, Pp 1-4 (2018) JA Clinical Reports |
| ISSN: | 2363-9024 |
| Popis: | Background One-lung ventilation under general anesthesia is necessary for thoracic surgery, but this procedure is often difficult in surgery for patients with cardiopulmonary failure. Non-intubated video-assisted thoracic surgery (VATS) is performed under local anesthesia for patients with respiratory failure, but has not been performed for patients with circulatory failure. Here, we report management of two patients with cardiopulmonary failure who underwent non-intubated VATS with paravertebral block and infiltration anesthesia. Case presentation Case 1 was a 79-year-old male with dyspnea at rest due to left large pleural effusion and cardiac dysfunction who underwent thoracoscopic pleural biopsy with paravertebral block under spontaneous breathing. The patient was also receiving dialysis. Case 2 was a 53-year-old male who developed empyema due to large pleural effusion, resulting in a poor general condition and cardiac dysfunction, and underwent video-assisted empyema curettage only with infiltration anesthesia under spontaneous breathing. In both patients, intraoperative respiration and circulation remained stable with values similar to those present preoperatively, and there were no problems after surgery. Conclusions We safely anesthetized two patients with difficulty to general anesthesia by ensuring sufficient regional anesthesia during VATS under spontaneous breathing. These cases suggest that regional anesthesia for non-intubated VATS can contribute to maintain intra- and postoperative respiration and circulation in patients with cardiopulmonary failure. |
| Databáze: | OpenAIRE |
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