Case Report: Incremental Use of Fentanyl as a Strategy for High-Risk Patient with Non-Intubated Video-Assisted Thoracoscopic Surgery

There are few preliminary studies and reviews of non-intubated thoracic surgery (NITS) in recent years considering its feasibility and safety. Anesthetic management also became an issue due to lack of standard protocol and wide range of surgical procedures. The case we presented is a 45-year-old male, who had systemic sclerodermatitis, suffered from recurrent spontaneous pneumothorax because of huge bullae formation in the lung. The patient underwent bullectomy via non-intubated video-assisted thoracoscopy with local anesthesia and neuroleptanesthesia successfully. He had fast recovery from surgery, which allowed early rehabilitation. Here, we share our anesthetic experience and review other current management.