[Anesthesia for Thoracoscopic Surgery in Children].

Abstract

Video-assisted thoracoscopic surgery (VATS) has many advantages over open thoracic surgery. Safety and efficacy of VATS in children have been confirmed, and VATS should be a common surgery. VATS and single-lung ventilation (SLV) induce various chafiges of ventilation and perfusion. In pediat- ric patients, thoracic surgery with lateral d6cubitus position has an increased risk of hypoxia and circula- tory insufficiency. VATS has gained wide acceptance in pediatric tho- racic surgery. Therefore, SLV is more required for pediatric patients. SLV for pediatric patients, selective main stem intubation with a conventional single lumen tube, bronchial blocker, Univent tubeTM and double lumen tube are used. In neonatal patients and infants, Fogartye catheter or Wedge Pressure CatheterTm is often used as a bronchial blocker. Indication and method of SLV should be determined by patient's age, body weight, complications and operative procedures. Anesthesia is maintained with inhalation and/or intravenous anesthesia. Various approaches are needed for maintaining oxygenation and gas exchange. For postoperative analgesia, nonsteroidal anti-in- flammatory drugs (NSAIDs), acetoaminophen, and opioids are given via oral, rectal and intravenous routes. Regional analgesia (epidural analgesia, para- vertebral nerve blocks, intercostal nerve blocks etc) is effective for postoperative pain.

• Authors: Atsushi Yamashita, Hirotsugu Okamoto
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 65 Issue 9 Pg. 930-936 (09 2016) ISSN: 0021-4892 [Print] Japan
• PMID: 30358320 (Publication Type: Journal Article)

Topics

• Analgesia
• Child
• Humans
• One-Lung Ventilation (methods)
• Pain, Postoperative (drug therapy)
• Respiration
• Thoracic Surgery, Video-Assisted (methods)