ANESTHESIA FOR THORACOSCOPY

Abstract

Thoracoscopic surgery is considered a recent advance in endoscopic surgical technique for diagnosis and management of many chest dise.ases without need for usual thoracotomy which has a high risk of cardiopulmonary complications, thus thoracoscopy offers relatively safe, simple and reliable alternative technique, the use of thoracoscope entails the deflation of the lung at the site of introduction of' the trocar, a double lumen endotracheal tube, and one lung anaesthesia.

In this essay, we described the details of anatomy of the chest wall, trachea and its main bronchi with the suiTounding relations, mediastinum, • lung and its • main bronchopulmonmy segments with the surrounding relations, and pleura. This to help the anesthesiologist to understand the anatomical aspects of surge1y and location of disease.

Then we shift to the second chapter which include the physiology of respiration, distribution of pulmonary perfusion, distribution cif pulmonary ventilation, respiratory function during anesthesia.

After that we mentioned the physiology of respiration when patient in • the lateral decubitus position which is the usual position during thoracoscopy, then physiology of one lung anesthesia when operation is started after double lwnen tube is introduced.

In the third chapter we talked about preoperative prior in which we • prepare the patient for surgery, evaluate the cardiopulmonary functions by different investigations, then how we premedicate him before operation.