Name of the Procedure:

Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty.

Summary

This procedure involves administering anesthesia for surgeries that open the chest cavity to access the lungs, pleura (linings around the lungs), diaphragm, and mediastinum (space in the chest between the lungs). These surgeries may involve removing a part of the lungs and reconstructing the chest wall (thoracoplasty).

Purpose

The procedure is primarily conducted to manage and alleviate medical conditions affecting the lungs, pleura, diaphragm, and mediastinum which may include tumors, infections, or severe lung diseases. The goal is to provide safe and effective anesthesia to allow the surgeon to perform necessary operations such as pulmonary resection (removal of lung tissue) and thoracoplasty (chest wall reconstruction) with minimal patient discomfort and maximum safety.

Indications

• Lung cancer or other pulmonary tumors
• Severe infections affecting the lungs or pleura
• Traumatic injuries requiring surgical intervention
• Congenital or acquired abnormalities of the diaphragm
• Pleural diseases causing respiratory complications

Preparation

• Patients usually need to fast for at least 8 hours before the procedure.
• Medication adjustments may be necessary, especially for blood thinners or medications affecting the respiratory system.
• Pre-operative assessments may include blood tests, chest X-rays, CT scans, lung function tests, and electrocardiograms (ECG).

Procedure Description

1. The patient is positioned appropriately, often lying on their side.
2. An intravenous (IV) line is established for administering medications and fluids.
3. General anesthesia is administered, rendering the patient unconscious and unable to feel pain.
4. Additional regional anesthesia (such as epidural anesthesia) may be used for postoperative pain control.
5. The anesthesiologist monitors vital signs and adjusts anesthesia levels throughout the surgical procedure.
6. The surgeon makes an incision in the chest (thoracotomy) to access the targeting area.
7. Surgical procedures, such as pulmonary resections or thoracoplasty, are performed as required.
8. Once the surgery is complete, anesthesia is slowly reduced, and the patient begins to wake up in a controlled environment.

Duration

The duration can vary but typically ranges from 3 to 6 hours, depending on the complexity of the surgery.

Setting

This procedure is performed in a hospital setting, specifically in a fully-equipped surgical suite.

Personnel

• Anesthesiologist
• Thoracic surgeon
• Surgical nurses
• Anesthesia technicians
• Respiratory therapists

Risks and Complications

• Common risks include nausea, vomiting, and post-operative pain.
• Serious but rare complications may include respiratory issues, infections, blood clots, bleeding, or adverse reactions to anesthesia.
• Follow-up interventions may be necessary to manage complications.

Benefits

• Relief from serious respiratory symptoms and conditions.
• Potential improvement or cure of underlying medical issues affecting the lungs or chest area.
• Enhanced quality of life post-recovery.

Recovery

• Patients are typically monitored in the intensive care unit (ICU) immediately after surgery.
• Post-procedure care includes pain management, respiratory therapy, and close monitoring of vital signs.
• Recovery time can range from a few weeks to several months, with activity limitations and scheduled follow-up appointments for monitoring progress.

Alternatives

• Non-surgical management (medications, chemotherapy, radiotherapy) when applicable.
• Less invasive procedures like bronchoscopy or percutaneous interventions.
• Each alternative carries different risks, benefits, and effectiveness based on the individual patient’s condition.

Patient Experience

• Patients will be unconscious during the procedure due to general anesthesia.
• Post-operatively, they may experience pain at the incision site, which can be managed through medications and nerve blocks.
• Patients might feel fatigued and discomfort as they regain full consciousness and begin physical recovery. Pain management and supportive care are integral parts of recovery to ensure comfort.