HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mark R. Katlic Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Katlic, M. R. Search for Related Content PubMed PubMed Citation Articles by Katlic, M. R. Related Collections Anesthesia Lung - other Pleura Minimally invasive surgery

Eur J Cardiothorac Surg 2006;30:529-532
© 2006 Elsevier Science NL

Video-assisted thoracic surgery utilizing local anesthesia and sedation

Geisinger Wyoming Valley Medical Center, 1000 East Mountain Drive, Wilkes-Barre, PA 18711, USA

Received 6 April 2006; received in revised form 12 June 2006; accepted 26 June 2006.

^_* Corresponding author. Tel.: +1 570 820 6017; fax: +1 570 821 2306. (Email: mrkatlic{at}geisinger.edu).

Objective: Video-assisted thoracic surgery (VATS) is usually performed with general anesthesia and double-lumen endotracheal intubation, but minor procedures have been carried out with patients spontaneously breathing and with epidural or regional analgesia. We have broadened our indications for VATS utilizing purely local anesthesia and sedation. Methods: The medical records of all patients undergoing VATS under local anesthesia and sedation at Geisinger Wyoming Valley Medical Center between 7/1/02 and 6/1/06 were reviewed. All procedures were performed in the operating room with patients in full lateral position; no patient had endotracheal intubation or epidural or nerve block analgesia. Results: One hundred and fifteen patients, ranging in age from 21 to 88 years and in size from 40 to 172 kg, underwent 126 video-assisted thoracic operations: pleural biopsy/effusion drainage with or without talc 81, drainage of empyema 21, lung biopsy 18, evacuate hemothorax 3, pericardial window 2, biopsy chest wall mass 1. No patient required intubation or conversion to thoracotomy. Three patients who underwent lung biopsy died of their underlying disease (cytomegalovirus and pneumocystis, primary amyloidosis, metastatic cancer to contra-lateral lung) on postoperative days 18, 14, and 4, respectively. One patient developed transient renal insufficiency attributed to ketorolac. Conclusion: VATS utilizing local anesthesia and sedation is well tolerated, safe, and valuable for an increasing number of indications.

Key Words: Video-assisted thoracic surgery (VATS) • Thoracoscopy • Anesthesia • Pleural effusion • Biopsy