Korean J Anesthesiol.  1993 Dec;26(6):1294-1299. 10.4097/kjae.1993.26.6.1294.

Anesthesia for Transthoracic Endoscopic Sympathectomy

• Kim JH
• Lee SK
• Ok SY
• Kim SI
• Kim SY

• KMID: 1933969
• DOI: http://doi.org/10.4097/kjae.1993.26.6.1294

Abstract

Technological advances in video camera, high resolution monitors and optical systems have produced considerable process in endoscopic surgery. Recently we have experienced transthoracic endoscopic sympathectomy(TES) for the treatment of Buerger's disease of both hands in a 47 years old male healthy patient. For the TES, one lung ventilation is necessary to provide adequate surgical access, so this patient had general anesthesia with a disposable left sided Robertshaw double lumen endobronchial tube. The patient was monitored for arterial pressure, herat rate, ECG, pulse oximetry, end-tidal carbon dioxide concentration, peak inspired airway pressure and arterial blood gas analysis. Potenial intraoperative problems wese hypoxemia during one-lung anesthesia, hypotension and hypercarbia occurred by insufflation of carbon dioxide into the chest cavity. Our patient also developed moderate hypoxemia which was corrected by application of high frequency jet ventilation with low driving pressure during right sided operation, and increased significantly arterial carbon dioxide tension about 8-12 mmHg during one lung ansthesia. We reviewed our experience and discussed the anesthetic technique and perioperative problems encounterd in the patient undergoing transthoracic endoscopic sympathectomy for Buerger's disease.

Keyword

Buerger`s disease; One-lung anesthesia; Hypoxemia; Transthoracic endoscopic sympathectomy

MeSH Terms

Anesthesia*
Anesthesia, General
Anoxia
Arterial Pressure
Blood Gas Analysis
Carbon Dioxide
Electrocardiography
Hand
High-Frequency Jet Ventilation
Humans
Hypotension
Insufflation
Lung
Male
Middle Aged
One-Lung Ventilation
Optical Devices
Oximetry
Sympathectomy*
Thorax
Thromboangiitis Obliterans
Carbon Dioxide