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Review Article|Articles in Press

ANESTHESIA FOR NON-INTUBATED VIDEO-ASSISTED THORACOSCOPIC SURGERY

Published:March 04, 2023DOI:https://doi.org/10.1053/j.jvca.2023.02.048

      Abstract

      With the growing adoption of Enhanced Recovery after Surgery protocols across all surgical groups including thoracic surgery, coupled with improved video assisted thoracoscopic surgery (VATS) equipment and techniques, non-intubated thoracoscopic surgery has gained significant popularity in recent years. The avoidance of tracheal intubation with endotracheal tube or double lumen tube and general anesthesia may reduce or eliminate the risks associated with traditional mechanical ventilation, one-lung ventilation and general anesthesia. Studies have shown a trend towards better preservation of postoperative respiratory function and improved postoperative lengths of hospital stay, morbidity and mortality, however these have not been conclusively proven. This review article discusses the advantages of non-intubated VATS, the types of thoracic surgery in which this technique has been described, patient selection, appropriate anesthetic techniques, surgical concerns, potential complications relevant to the anesthesiologist during the conduct of non-intubated VATS surgery, and suggested management of these complications.

      Keywords

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