24. Anesthesia for Thoracic Surgery

  1. George A. Gregory MD5,6 and
  2. Dean B. Andropoulos MD, MHCM7,8
  1. Grant McFadyen MBChB, DA(SA), FRCA1,2,
  2. Stefan Budac MD1,2,
  3. Michael Richards BM, MRCP, FRCA1,2 and
  4. Lynn D. Martin MD, FAAP, FCCM3,4

Published Online: 9 DEC 2011

DOI: 10.1002/9781444345186.ch24

Gregory's Pediatric Anesthesia, Fifth Edition

Gregory's Pediatric Anesthesia, Fifth Edition

How to Cite

McFadyen, G., Budac, S., Richards, M. and Martin, L. D. (2012) Anesthesia for Thoracic Surgery, in Gregory's Pediatric Anesthesia, Fifth Edition (eds G. A. Gregory and D. B. Andropoulos), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444345186.ch24

Editor Information

  1. 5

    Department of Anesthesia and Perioperative Care, University of California San Francisco (UCSF), San Francisco, CA, USA

  2. 6

    Department of Pediatrics, University of California San Francisco (UCSF), San Francisco, CA, USA

  3. 7

    Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA

  4. 8

    Anesthesiology and Pediatrics, Baylor College of Medicine, Houston, TX, USA

Author Information

  1. 1

    Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, WA, USA

  2. 2

    Seattle Children's Hospital, Seattle, WA, USA

  3. 3

    Department of Anesthesiology & Pain Medicine, Bellevue Clinics and Surgery Center, Seattle Children's Hospital, WA, USA

  4. 4

    University of Washington School of Medicine, Seattle, WA, USA

Publication History

  1. Published Online: 9 DEC 2011
  2. Published Print: 3 FEB 2012

ISBN Information

Print ISBN: 9781444333466

Online ISBN: 9781444345186

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Keywords:

  • anterior mediastinal mass;
  • bronchial blocker;
  • congenital cystic lung disease;
  • empyema;
  • one-lung ventilation;
  • paravertebral block;
  • pectus excavatum;
  • thoracic epidural;
  • thoracoscopy

Summary

Thoracic surgery and anesthesia for thoracic surgery for pediatric patients have changed significantly over the last 15 years due to the advent of video-assisted thoracoscopic surgery, robotic surgery, and the anesthetic practice required to facilitate this type of surgery. While the less invasive approach of video-assisted thoracoscopic surgery has changed certain aspects of the perioperative and postoperative management of the pediatric patient requiring thoracic surgery, thoracotomy remains a relatively frequent surgical procedure, particularly in very small infants. Hence pediatric anesthesia providers must have the ability to manage anesthesia for both forms of surgery within the thoracic cavity. This chapter reviews the pathophysiology of one-lung ventilation, discusses the anesthetic practice and tools necessary to facilitate the perioperative management of patients with thoracic problems, and discusses in detail some of the finer nuances of certain specific thoracic surgical challenges within the pediatric population.