Anaesthetic techniques Anaesthetic techniques for thoracic surgery (Table 10.1) are little different from those used in other forms of major surgery. Anaesthesia is induced intravenously and endobronchial intubation is performed following the administration of a non-depolarizing neuromuscular blocking drug. The depolarizing agent suxamethonium is indicated, however, if a difficult laryngeal int...

BACKGROUND Despite an increasing need, there is limited experience of double-lumen endobronchial tube (DLT) placement using video laryngoscope. We evaluated DLT intubation using an OptiScope, a rigid video-stylet with a malleable tip derived from the Clarus Video System, in comparison with a Macintosh laryngoscope. METHODS After airway evaluation and anaesthetic induction, Cormack and Lehane ...

Hazards of carbon dioxide insufflation during thoracoscopy Editor,—I read with interest the review article on the anaesthetic implications of thoracoscopic sympathectomy. 1 When endobronchial anaesthesia is used, carbon dioxide may be insufflated only initially into the ipsilateral pleural space to augment lung collapse. In contrast , when a tracheal tube is used, carbon dioxide is insufflated ...

Anaesthetists and pulmonologists are well trained to follow the “can’t intubate, can’t oxygenate” (CICO) protocol but procedure is rarely practised. This case report concerns an elective patient scheduled for endobronchial ultrasound bronchoscopy (EBUS) because of suspected sarcoidosis. Based on known medical history, anaesthesia EBUS was initiated with a laryngeal mask. The airway turned out b...

There are many methods for achieving one-lung ventilation (OLV) during thoracic surgery in neonates and the accuracy of OLV may affect postoperative outcome. The authors have performed OLV using a 5 Fr Arndt endobronchial blocker (AEB, Cook Inc., Bloomington, IN, USA) on a neonate diagnosed with congenital cystic adenomatoid malformation and respiratory distress syndrome (RDS) associated with m...

Inflammatory endobronchial polyp is a rare disease mostly encountered in asthmatic patients. Chronic airway and foreign material irritation or thermal injury may result in the formation of granulated tissues and become polypoid mass. Herein, we describe a 52-year-old man with severe respiratory distress and infection with 35 years history of smoking. He had an obstructive pattern in his pulmona...

Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near ...