Anaesthetic agents for thoracic surgery: what's best?

Purpose Of Review: Pneumonectomy is still associated with a 5% 30-day mortality in a large series involving a variety of anaesthetic agents and techniques.

Recent Findings: As well as the immediate 'anaesthetic' complications of pain, nausea and vomiting and respiratory dysfunction, differences between anaesthetic agents have emerged in systemic inflammation, postoperative cognitive dysfunction, immune suppression and cell signalling after surgery.

Summary: No one anaesthetic agent has emerged as best. There is a trade-off between initial success and long-term problems or vice versa.