Thoracic: VATS (One-Lung Ventilation)

Abstract

In this chapter the essential aspects of anesthes for video-assisted thoracic surgery (VATS) are discussed. The algorithm for determining correct double-lumen tube (DLT) placement, troubleshooting hypoxia in the DLT-ventilated patient, and management of the airway are discussed. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics include assessment of respiratory function and cyanosis. Issues discussed relate to intraoperative management include monitoring, epidural catheter placement, use of a double-lumen tube, single-lung ventilation, and addressing hypoxia and massive bleeding. Postoperative concerns addressed include extubation, pain control and altered mental status.