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Postoperative care after thoracic surgery in the times of ERAS.
Best Pract Res Clin Anaesthesiol
March 2024
Department of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. Electronic address:
This review documents the importance of postoperative interventions that accelerate the functional recovery of the thoracic surgical patient. Enhanced recovery after surgery (ERAS) pathways aim to mitigate the harmful surgical stress response. Improvements to the entire patient pathway, by removing unnecessary care elements while introducing evidence-based interventions, have synergistic effects.
View Article and Find Full Text PDFThe current (and possible future) role of opioid analgesia in lung cancer surgery.
Best Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
View Article and Find Full Text PDFChallenges in acute postoperative pain management in thoracic surgery.
Best Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology, Columbia University, 622 W 168th St, New York, 10032, NY, United States. Electronic address:
Effective pain control is crucial in the management of thoracic surgical patients since it reduces postoperative morbidity and promotes recovery. These patients have co-existing respiratory diseases and impaired pulmonary function, which may be further impaired by surgery. With the adoption of minimally invasive surgical techniques and an emphasis on enhancing recovery after surgery, multimodal analgesia has gained popularity as a way to reduce perioperative opioid use and its associated adverse events such as respiratory depression.
View Article and Find Full Text PDFAnesthetic considerations for perioperative ECMO in lung transplantation.
Best Pract Res Clin Anaesthesiol
March 2024
Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA. Electronic address:
The care for lung transplantation patients is a complex, multidisciplinary coordination of physician and non-physician teams throughout the perioperative period. The diversity of etiologies of recipient end-stage lung disease further complicate care, as recipients often present with concomitant end-stage cardiac disease. Recently, the use of extracorporeal membrane oxygenation has become the mechanical circulatory support of choice to provide cardiopulmonary stability throughout the perioperative period.
View Article and Find Full Text PDFUpdates in lung isolation techniques.
Best Pract Res Clin Anaesthesiol
March 2024
Cardiothoracic Anesthesia, Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; Cardiothoracic Anaesthesia Unit, Department of Anaesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansour, Egypt. Electronic address:
Innovations and challenges for lung separation or isolation have evolved during the last few years. In this chapter, we present the up-to-date, robust evidence available during the previous five years supporting the positions of the different devices, techniques, and tricks for their use in adult and pediatric patients undergoing various thoracic surgical interventions. Additionally, we presented an update on lung isolation in patients with airway difficulty and the suggested training level to master these techniques.
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