Name of the Procedure:

Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation

Summary

In this procedure, anesthesia is administered to facilitate surgeries on the thoracic spine and spinal cord through an approach that accesses the spine from the front of the chest. Notably, this anesthetic technique does not require the use of one-lung ventilation.

Purpose

The purpose of this anesthetic approach is to ensure the patient remains pain-free and immobile during surgery on the thoracic spine and spinal cord. The expected outcome is to enable surgeons to perform complex spinal procedures while maintaining the patient's stability and comfort.

Indications

• Degenerative spine diseases
• Spinal tumors or cysts
• Traumatic spine injuries
• Spinal deformities

Patient criteria:

• Need for surgery on the thoracic spine
• Unnecessary or contraindicated one-lung ventilation

Preparation

• Fasting for approximately 8 hours before the procedure.
• Adjustments or cessation of certain medications as advised by the anesthesiologist.
• Pre-procedure diagnostic tests, such as blood work and imaging studies.

Procedure Description

1. Pre-anesthetic assessment and patient preparation.
2. Placement of intravenous (IV) lines and monitoring equipment.
3. Administration of general anesthesia to render the patient unconscious and pain-free.
4. Continuous monitoring of vital signs, respiratory function, and oxygenation.
5. Intubation may be performed for airway management.
6. Pain management through epidural or other regional anesthesia techniques may be used.
7. Surgery proceeds with the thoracic spine accessed through an anterior transthoracic approach.
8. Anesthesia is maintained throughout the surgery.

Duration

The procedure duration varies but typically ranges from 3 to 6 hours, depending on the complexity of the spinal surgery.

Setting

Performed in a hospital operating room specifically equipped for thoracic and spinal surgeries.

Personnel

• Anesthesiologist
• Surgeon specializing in spinal surgery
• Surgical nurses
• Anesthesia technicians

Risks and Complications

Common risks:

• Sore throat from intubation
• Nausea and vomiting
• Mild bleeding or bruising at IV sites

Rare risks:

• Respiratory complications
• Adverse reaction to anesthesia
• Blood clots
• Infection

Complications are managed with appropriate medical interventions as necessary.

Benefits

• Effective pain control allowing for complex spinal surgeries.
• Reduced movement during surgery enhances precision and safety.
• Avoidance of one-lung ventilation may reduce associated risks.

Recovery

• Close monitoring in a recovery area post-surgery.
• Pain management is continued with medications as needed.
• Instructions are provided for wound care and physical activity restrictions.
• Follow-up appointments to monitor recovery progress.

Alternatives

• Surgery with the use of one-lung ventilation, which may be required for some conditions.
• Non-surgical treatments, such as physical therapy or medications, for certain degenerative conditions.
• The pros of this anesthesia approach include potentially fewer complications related to lung ventilation.

Patient Experience

• During the procedure, the patient is under general anesthesia and will not be conscious.
• Post-procedure, the patient may experience sore throat, nausea, and mild pain.
• Pain management strategies include medications and comfort measures like positioning pillows and warm blankets.