AI Article Synopsis
- This text summarizes the various airway and anesthetic management options available to anesthesiologists during thoracic surgery, focusing on the importance of balancing patient needs with optimal surgical conditions.
- Over the years, advancements in technology and techniques have shifted airway surgery from spontaneous breathing with halogenated agents to safer methods under general anesthesia, which are important for increasingly complex patient cases.
- The review highlights the historical context, current practices, and potential future directions of airway and anesthetic management, emphasizing the need for collaboration among medical teams to ensure patient safety and surgical success.
Article Abstract
Objective: To discuss and summarize the literature for airway and anesthetic management tools the anesthesiologist can use for airway surgery to both successfully manage the patient's physiological needs and provide the surgeon the optimal surgical conditions with which to perform the surgery safely.
Background: The airway and anesthetic management of patients presenting for thoracic surgery poses the anesthesiologist with a unique set of challenges, but also a unique set of opportunities to artfully utilize and adapt a variety of management options that has developed over several decades of innovation. Sixty years ago, airway surgery was initially performed with the patient spontaneously breathing and providing anesthesia with halogenated agents and airway topicalization. As medicine entered the latter half of the twentieth century with its development of new airway devices and modern anesthetic agents, most airway surgeries could be safely performed under general anesthesia with secured airways. Today, with continued technological advancements in surgical techniques and an expanding population of challenging patients, the application of nonintubated anesthetic techniques and extracorporeal support is on the rise.
Methods: We conduct a narrative review of the literature on the history of airway and anesthetic management for thoracic surgery, the current management methods and evidence for each modality, and discuss future directions for the field.
Conclusions: While the airway and anesthetic management for airway surgery is challenging, the anesthesiologist has a variety of options including cross-field ventilation, jet ventilation, nonintubated techniques, and extracorporeal support to safely care for the patient. Whichever methods are chosen for the patient and surgery, thoracic surgery remains uniquely positioned in its need for close sharing and collaboration of all airway and anesthetic management decisions between the anesthesiologist and the surgeon.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743527 | PMC |
| http://dx.doi.org/10.21037/tlcr-21-917 | DOI Listing |
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